Health care worker, Insurance Verification, claims processer, prior au
Resume:
Darlene Morgan
*** ****** **, ***** ****, PA ****3
******.***********@*****.***
SUMMARY
A dedicated medical professional with a proven track record of providing superior assistance to patients and medical personnel for the last twenty years. Experienced in providing administrative and clinical support to healthcare facilities. As well as performing tasks such as maintaining patient records, updating patient accounts, and handling all patient and facility correspondence, as well as providing back-office support for the providers, which includes giving injections, performing EKGs, and helping providers with procedures. Bringing forth excellent customer service skills, an understanding of the medical industry, important medical terminology, and medical professionalism.
WORK EXPERIENCE
September 2021-May 2022
Insurance Verification Specialist, Cardinal Health, WFH (Dublin, OH)
•Verified government and non-government insurance information for accuracy and completeness.
•Obtained all necessary documentation to process the order/claim
•Review and process medical claims for accuracy and completeness.
•Verify patient information, procedure codes, and insurance
coverage.
•Use ICD-10 codes, HCPCS for all claim processing.
•Communicate with healthcare providers, insurance companies, and patients regarding claims.
•Utilize financial software for claims processing.
•Ensure timely submission of claims to insurance companies.
•Identifies payer's authorization/referral requirements.
January 2020-July 2020
Certified Medical Assistant, Heritage Valley Medical Group, Ellwood City, PA
•Performed laboratory tests, such as blood draws, urinalysis, and EKGs, Rapid Strep Tests, & Flu A & B.
•Conducted medical office administrative tasks, including answering phones, greeting visitors, imputing patients data into the EHR, verifying patients insurance eligibility.
•Obtained prior authorization for radiology, pharmaceuticals and surgeries as needed thru patients insurances.
•Completed medical billing and coding per office policies.
•Administered patient care, including vital signs, physical examinations, and medications/ immunization(vaccines).
•Prepared treatment rooms for patient examinations by keeping them neat, orderly and well stocked with supplies.
•Scheduled patient appointments, including any appointments needed with specialists, radiology, and/or the lab.
•Provided patient education and instruction on proper health care and wellness.
•Obtained patient histories and vital signs, documenting any abnormal findings.
•Maintained accurate patient records and documents, ensuring compliance with HIPAA regulations.
September 2018-June 2019
Certified Medical Assistant, Butler Medical Providers, Mars, Pa
• Performed laboratory tests, such as blood draws, urinalysis, and EKGs, Rapid Strep Tests, & Flu A & B.
•Conducted medical office administrative tasks, including answering phones, greeting visitors, imputing patients data into the EHR, verifying patients insurance eligibility.
•Obtained prior authorization for radiology, pharmaceuticals and surgeries as needed thru patients insurances.
•Completed medical billing and coding per office policies.
•Administered patient care, including vital signs, physical examinations, and medications/ immunization(vaccines).
•Prepared treatment rooms for patient examinations by keeping them neat, orderly and well stocked with supplies.
•Scheduled patient appointments, including any appointments needed with specialists, radiology, and lab.
•Provided patient education and instruction on proper health care and wellness.
•Obtained patient histories and vital signs, documenting any abnormal findings.
•Maintained accurate patient records and documents, ensuring compliance with HIPAA regulations.
November 2016-September 2018
Certified Medical Assistant, Allegheny Clinic, Pittsburgh, PA
• Performed laboratory tests, such as blood draws, urinalysis, and EKGs, Rapid Strep Tests, & Flu A & B.
•Conducted medical office administrative tasks, including answering phones, greeting visitors, imputing patients data into the EHR, verifying patients insurance eligibility.
•Obtained prior authorization for radiology, pharmaceuticals and surgeries as needed thru patients insurances.
•Completed medical billing and coding per office policies.
•Administered patient care, including vital signs, physical examinations, and medications/ immunization(vaccines).
•Prepared treatment rooms for patient examinations by keeping them neat, orderly and well stocked with supplies.
•Scheduled patient appointments, including any appointments needed with specialists, radiology, and lab.
•Provided patient education and instruction on proper health care and wellness.
•Obtained patient histories and vital signs, documenting any abnormal findings.
•Maintained accurate patient records and documents, ensuring compliance with HIPAA regulations.
November 2011-November 2016
Insurance Coordinator, West Penn Allegheny Health Systems/AHN, Pittsburgh, PA
•Verified government and non-government insurance information for accuracy and completeness.
•Obtained all necessary documentation to process the order/claim.
•Review and process medical claims for accuracy and completeness.
•Verify patient information, procedure codes, and insurance coverage.
•Use ICD-10 codes, HCPCS for all claim processing
•Communicate with healthcare providers, insurance
companies, and patients regarding claims.
•Utilize financial software for claims processing.
•Ensure timely submission of claims to insurance companies.
•Identifies payer's authorization/referral requirements.
EDUCATION
Certificate in Medical Billing & Coding ~ 2023-2024
Community College of Beaver County, Beaver, PA
Medical Terminology, Anatomy and Physiology, Pathophysiology, Pharmacology, ICD-10-CM, CPT, HCPCS
Associates Degree in Applied Science ~ 1995-1997
Butler County Community College, Butler, PA
AAS in Medical Assisting
Medical Terminology, Anatomy and Physiology, Clinical Procedures, Pharmacology, Medical Law and Ethics, Medical Office Procedures, General Psychology
SKILLS
Anatomy, HCPCS, ICD-10, Medical Terminology, Pharmacology, Multitasking, Detail Oriented, Communication Skills(written and verbal), Microsoft Office, Organizational Skills, Problem Solving Skills, Work Independently, Team Player, Time Management, Analytical Thinking, Flexible/Flexibility, Critical Thinking
CERTIFICATIONS
Certified Medical Assistant
NHA - National Health career Association
Certification Number ~ #R4Y8E8E5
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