Accounts Receivable Microsoft Office
Resume:
Ashley Thompson
Address ***** ****** ***** ** **** TX 77449
Phone: 312-***-****
**************.****@*****.***
Skills
Administrative Skills
●Trained in Microsoft Office 2010
●Skilled in proofreading and creating documents
●Patient reception
●Handling multi line phone system
●Proficient in: Microsoft Office
●Type 40 WPM
●Grasp the back office concerning ICD-9 and DRG procedural classification with use of Electronic Health Record
●Accounts receivable and account payable knowledge
●Knowledge of medical EMR systems (Athena, Cerner, epic and etc.)
Highlights of Qualifications
●Advanced knowledge of Medical Terminology and Anatomy
●Current CPR Certification
●Ability to work well under pressure
●Excellent communication skills
●Follow directions well and works well with minimum supervision
●Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization.
●Familiarity with ICD-10 and CPT codes and procedures.
●Ability to review and understand patient medical documentation.
●Ability to independently identify and understand medical necessity requirements.
●Task-oriented and organizational skills; ability to complete tasks timely
●Detail-oriented focus; being careful about detail and thorough in completing work tasks.
●Ability to work independently and as a team.
●Ability to adapt with flexibility.
●Effective communication skills (written/verbal
Experience
PCC Wellness Center Chicago, IL – Referral Coordinator
Prioritize incoming authorization requests according to urgency.
Generate, verify, and oversee the complete procedure authorization/referral process.
Manages and resolves day-to-day issues pertaining to pre-authorization, as needed.
Monitor provider network status and notify appropriate individuals of non-network status providers.
Obtain authorization by fax, payer website or by phone and follow up regularly on pending cases.
Notify appropriate departments for approvals and denials.
Initiate and assist with appeals for denied authorizations.
Notify and coordinate P2P (Peer to Peer) requests with the appropriate department.
Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
Contact patients as needed to discuss authorization status.
Effectively maintain, monitor, and update payer medical policy guidelines to manage authorization requirements.
Request, review, and submit necessary patient documentation as needed.
Assists with patient scheduling and inquiries, as necessary.
Effectively utilizes ICD 10, CPT, HPCPS, modifiers and/or other codes according to coding guidelines.
Communicates effectively with provider and/or all appropriate parties regarding missing information such as CPT, diagnoses codes, documents, operative reports, etc. to ensure proper authorization processing.
Communicates effectively with other departments regarding changes and/or updates with patient accounts and status.
Manages the status of accounts and identify inconsistencies.
Responds to billing inquiries.
Uses downtime efficiently; is aware of team members workload.
Communicates company goals, expectations, updates, and/or deadlines timely.
Makes recommendations on workflow improvement as needed.
Reports statistics as required.
August 2022- current
West suburban hospital Oak Park, IL - Patient Access Department (ER Registration and Admitting)
2
●Registration
●Answer inbound call
●Emergency room registration
●Admitting patients into hospitals
●Verify insurance information
●Greet patients
●Customer service
●Admitting
October 2019 – February 2023
Oak Street Health oak brook IL – Referral coordinator
Building and maintaining partnerships with identified service providers. • Assisting new and returning patients with scheduling appointments.
Reviewing medical records for completion and accuracy to follow insurance standards.
Answering office phone calls. Assist patients with questions regarding referrals.
Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s).
Work/address the referrals that remain open to determine if patient received the referred services. Contact Referred to provider to obtain consultation notes. Contact patients per established policy and procedure to ensure they receive referred services. Close referrals per established policy and procedure.
Build and maintain relationships with Payer/Plan representatives and Oak street health clinic providers and staff; acts as a resource to answer questions and solve problems
Maintain accurate information regarding what services require prior authorization for each Payer/Plan.
Maintain accurate information regarding which external providers are contracted with each Payer/Plan.
Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling.
Monitor referral phases to maintain compliance
Monitor referral dashboards and work queues daily
Perform other duties as assigned.
September 2017- October 2019
St. Bernard Hospital, Chicago Illinois- Patient Access Department (ER Registration and Admitting)
●Registration
●Answer inbound call
●Emergency room registration
●Admitting patients into hospitals
●Verify insurance information
●Greet patients
●Customer service
●Complete end of day reports
●Run insurance batch
●Outpatient services such as surgeries (verify ins coverage and payments copay and deductibles )
January 2016- June 2017 (Budgetary Layoff/Eligible for rehire)
Family Christian Health Center, Harvey, Il – Patient Service Associate Answer inbound phone calls and function as a switchboard operator as necessary.
●Make appointments for patients. Process appointment cancellations and rescheduling due to change in provider schedules as assigned by the supervisor.
3
●Patient Registration Complete registration process for patient appointments, including demographic and insurance verification, patient management system data entry and revision, payment collection, chart creation, and other clerical work as necessary.
●Assist patients, or refer them as necessary, with questions and completion of forms or applications related to their insurance coverage, including Medicaid Presumptive Eligibility (MPE) applications, All Kids applications, Newborn Medicaid patients (BNOCY), HMO PCP transfer requests, Medicare and HMO enrollments, and secondary coverage issues.
●Prepare work area for the beginning of every business day, including clerical work, chart construction, and any other tasks as required by the department supervisor(s).
●Process missed appointments, error reports, insurance pre-verification reports, and other registration-related reports as necessary.
●Become familiar with and follow current protocols for all of the above-listed functions, as well as specialized functions such as the processing of lab-only visits, after-hours pharmacy payments, and other functions as necessary.
●Assist your assigned Care Team in completing tasks. Other universal working standards and documentation Greet and interact with all patients, staff and visitors in a pleasant and professional manner. Monitor and update work-lists and queues to ensure that no patients are subjected to unnecessary delays.
●Thoroughly, accurately, and promptly document all work completed
●Regularly check mail, and e-mail
●Work a reasonable schedule, perform other tasks required in support of the assigned care team,
August 2015- January 2016
Healthcare consortium of Illinois, Dolton Il - Case Manager Assistant
●Scheduling home and office visits
●Accompany Case manager to visits
●Making referrals and follow up appointments
●Inputting client information in database
●Keeping accurate filing system
●Operating copy and fax machines
●Working on computer system daily
●Ensuring Case manager have all clients’ needs before the end of business day ●
Completes all clients’ paperwork in file
●Assist clients to and from doctor's visits and some personal errands
Education
August 2011-May 2012
Computer Systems Institute, Chicago Il - Medical Assistant
Diploma: Healthcare Career Program
Everest College, Chicago Il - Administrative Assistant Certification:
Administration
References
Available upon request
Contact this candidate