Referral Specialist Customer Service
Resume:
LISA ROACH-DREW- **** EAST RENO MIDWEST CITY OK **110
405-***-****, ***********@*****.***
PROFESSIONAL SUMMARY
Over 10 years of Administrative and Customer Service experience
Extensive experience performing administrative support tasks, such as proofreading, transcribing
handwritten information, operating calculators add/or computers to pay records, invoices, balance
sheets, etc.
Proficient in utilizing Microsoft Outlook and Excel for email correspondence, report creation, and
client documentation
Skilled working with confidential documents and ensuring all information is recorded accurately
Excellent interpersonal skills
TECHNICAL SKILLS
Microsoft Outlook, Microsoft Excel Spread sheet, Microsoft Word, AS400k, Akurant, Symitar, MMIS,
Meditech IDX, EMR. EPIC, Medical Activation of Insurance
WORK EXPERIENCE
OU HEALTH
Referral specialist PsR / Scheduler 11-1-2021 - current Requirements and Responsibilities
Referral Specialist ensures patients have been cleared for specialty service office visits. Resolves pre-certification, registration and case-related concerns prior to a patient's appointment. Being a Referral Specialist gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient's financial obligations for services provided. Provides support to clinical staff in order to facilitate the administrative components of clinical referrals for various services. Additionally, Referral Specialist acts as a liaison between hospitals, physicians, health plans, vendors, and patients, or other referral sources. Schedule patients and Verifies insurance coverage and obtains authorizations if needed from insurance coverage. Enters referrals and documents communications, actions, and other data in an information system.
SR PATIENT ACCOUNT REP OKLAHAOMA CITY, OK 02-01- 2021 – 11-1-2021
Position Information: Under general supervision, may participate in any or all aspects of the patient
processing and accounts receivable functions of the organization including billing, charge entry, collection,
registration, scheduling, follow-up, coding, payment posting, and credit balance resolution. Essential
Duties:
•May reconcile daily IDX system receivables reports.
•May balance monthly transactions and provide summaries to faculty and department administration.
•Reviews patient admitting records and extracts information. Enters patient identification and
demographic information to billing system. Contacts agency representatives to verify type and extent of insurance coverage
•Reviews source documents to determine if sufficient data is present for processing.
Transcribes and or
verifies data from source documents in order to enter to the system. Batches and enters charges and
generate cash totals. Balances batches by comparing batch proofs to source documents.
•Acquires information from the organization for the patient, insurance carriers, or other entities.
May
interact with hospital patient accounting or records to obtain patient demographics or other billing
information. Operates hospital information system to obtain demographics, insurance, and status of
approvals or denials. Completes inpatient and outpatient documents processing. Assists with resolving
problems with IDX billing. Maintains records of charges, payments, and third party charges.
•Answers patients questions. Handles correspondence regarding collection activity and records results.
Identifies patient accounts for collection action. May receive patient payments and or issue payment
receipts. Initiates contact with patient and or third party carriers if there is a delay in responding
Record CPT and ICD-9 codes on billing forms.
•May process incoming and outgoing mail. May receive incoming calls and resolve issues.
MEDICAL BILLER 01-01-2016-01-01-2020
●Registering the patient and verifying their insurance coverage
●Collecting the information required to create a claim
●Working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
●Reviewing and appealing unpaid and denied claims
●Handling collections on unpaid accounts
●Managing the facility’s Accounts Receivable reports
●Answering patients’ billing questions
BAPTIST MEDICAL CENTER OKLAHOMA CITY, OK 05/2002 - 05/2004
COLLECTOR
Processed, prepared, and submitted forms and applications for coverage to insurance carriers
Reviewed and verified data, such as age, name, and address on insurance applications and policies
Modified, updated, and processed existing policies and claims to reflect any changes
Transcribed data to worksheets and entered data into computer for use in preparing documents
and adjusting account
Verified clients’ insurance coverage with primary and secondary carrier
Established repayment schedules, based on customers' financial situations and processed payments
PRESBYTERIAN HOSPITAL OKLAHOMA CITY, OK 11/2000 - 02/2002
RECEPTIONIST
Obtained various specified information, such as person's name, address, age, religious preference, or state of residency
Compiled, recorded, and coded results or data from interview or survey, using computer or specified form
Performed patient services, such as answering the telephone or assisting patients with financial
or medical questions
Reviewed data obtained from interview for completeness and accuracy
Assisted individuals in filling out applications or questionnaires
SPRINT PCS OKLAHOMA CITY, OK 02/1998 - 01/2000
COLLECTOR
Arranged for repayment or established repayment schedules, based on customers' financial situations and reactivated services.
Located and notified customers of delinquent accounts by mail or telephone to solicit payment
Advised customers of necessary actions and strategies for debt repayment
Persuaded customers to pay amounts due
Located and monitored overdue accounts, using computers and a variety of automated systems
Answered customer questions regarding problems with their accounts
Sorted and filed correspondence and performed miscellaneous clerical duties
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