Patient Access Customer Service

Healthcare professional with extensive experience in patient access

roles, ensuring smooth patient admissions and accurate data management. Proven ability to collaborate effectively with teams and adapt to dynamic healthcare environments. Known for excellent communication skills and strong attention to detail.

PROFESSIONAL SUMMARY

Alorica - Pharmacy Customer Care Associate

Remote • 08/2024 - Current

Community Health Systems - Scheduling Specialist

Remote • 12/2023 - 08/2024

WORK HISTORY

Develops and maintains positive customer relations and coordinates with functions within the company to ensure customer requests are handled and resolved appropriate and in a timely manner

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Interacts with internal and external customers (could include subscribers, providers, group or benefit administrators, physician offices, third party representatives, and other Blue Cross Plans) to provide claims, customer service, and/or membership support

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Completes necessary research to provide proactive, thorough solutions

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Displays ownership of service requests ensuring high quality resolution and follow-thru

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Supports and guides the customer with their personal options and decisions and helps the customer become knowledgeable and confident about using technology, tools and resources available to them

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Calendar Management: Maintaining and updating calendars with appointments, meetings, and events

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Appointment Scheduling: Coordinating appointments based on availability and preferences

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Conflict Resolution: Resolving scheduling conflicts and finding alternative times

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Communication: Communicating schedule changes and

updates to relevant parties

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Time Management: Ensuring that schedules are optimized and efficient

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• Key Skills:

Organizational skills: Ability to manage multiple tasks and prioritize effectively

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• Attention to detail: Ensuring accuracy and consistency in

SKILLS

• Medical office experience

• Insurance Verification

• Help Desk

• Epic

• Medical Records

• Data Entry Operator

• Data Entry

• Typing

• Medical Scheduling

• HIPAA

• Call center experience (10+ years)

• CPT coding

• Medical Billing

• Negotiation

• Communication skills

• ICD-10

• English

• Excel

• WPM:60

• Live Chat

• ICD coding

Skilled in Microsoft Word, Excel, and

Outlook (10+ years)

•

• Data-Entry

• HCPCS

• Technical Support

• Word

• Customer Service (10+ years)

• 2 years cash handling experience

• Photography

• Medical Coding

• Medical terminology (4 years)

• Cold Calling

• Hospital Experience (2 years)

High school diploma

Indian Capital Technology Center

Tahlequah, OK • 12/2021

Technical School Diploma: Medical Coding

and Billing

EDUCATION

CRYSTAL ROBERTSON E: *************@*****.***

P: 918-***-****

A: Tahlequah, OK 74464

Optum Services (formerly Change Healthcare) - Patient Access Representative

Remote • 02/2022 - 04/2024

Cherokee Nation W.W. Hastings Hospital - Patient Access Representative

Tahlequah, OK • 02/2021 - 11/2021

scheduling

Communication skills: Ability to effectively communicate with various stakeholders

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Problem-solving skills: Resolving scheduling conflicts and finding solutions

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• Time management skills: Efficiently managing and prioritizing tasks Obtains current patient information for established and new patients

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Accurately enters/updates patient information in scheduling system

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• Identifies payer source and verifies insurance eligibility Reviews scheduling system for needed updated demographics and consent forms

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• Provide messages or transfer the call to physicians and nurses Protects/observes patient confidentiality per policies and procedure

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Greets and assists all patients and visitors in a courteous and friendly manner in person, or via phone; assists them with general problems or complaints refers calls or takes accurate and complete messages

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Determines the eligibility of patients seeking healthcare, who have not been previously treated within Cherokee Nation Health System, by obtaining a Certification of Degree of Indian Blood

(CDIB) card or other documentary proof of tribal membership in a federally recognized tribe

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Assists patients in completing new or updated forms and gathers patient signatures as required

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Interviews all new and existing patients to obtain pertinent registration information necessary to ensure proper healthcare standards

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• For pre-registration purposes, this would be done via phone Verifies patient billing information through automated processes, registration interfaces, patient contact and payer contact by phone as necessary

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Scans all third party health cards and explains to patients why it is necessary for the facility to bill for services rendered

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Maintains current knowledge and implements the Privacy Act, Health Insurance Portability and Accountability Act (HIPPA), and other applicable patient confidentiality rules and regulations

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Enters Medicare, Medicaid, and private/commercial insurance

(i.e

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Medical, pharmacy, dental, behavioral health, vision, etc.) into electronic records system

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Reviews notes and communicates with the Patient Benefits Advocate/Patient Benefits Coordinator to exchange billing information and to ensure coordination of patient eligibility and

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Cherokee Nation Contract Health - Data Entry Tech I Tahlequah, OK • 07/2019 - 02/2021

benefits

• Serves as the front line of contact for the patients Must operate computerized programs and databases in order to enter, modify, and retrieve sensitive information/data into or from the electronic health record application(s); i.e., registration systems, and reporting systems

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Assesses patient status, obtains authorization of hospitalization and outpatient services prior to the services being rendered

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• Provides review and appeals to insurance companies as needed Answers calls from insurance companies, physician offices, hospitals, and patients using exemplary customer service

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Coordinates and works with providers, case management, insurance carriers, patient access billing, and the patient in securing authorization(s)/payment(s) or service(s) provided

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Communicates effectively and politely with patients when rescheduling appointments

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• Completes daily log forms for productivity calculations Uses strong interpersonal/human relationship skills in order to provide exceptional customer service with patients and co-workers, Internal and external

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• Directs patient inquiries to the appropriate personnel (i.e

• Medical personnel)

Verifies all patient information for accuracy and completeness

(demographic, insurance, emergency contacts, and eligibility)

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Files and retrieves applications and records in accordance with established procedures and filing systems; researches lost or missing applications or records

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• Orders and issues supplies as appropriate

• Operates copier, fax machines, or other office equipment

• Assists and trains other/new team members

Maintains system of scheduling the data entry in conjunction with appropriate deadlines

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Reviews documents to ensure completeness and

appropriateness prior to data entry

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Reads notes and instructions written on source documents and compares information with printouts to detect errors and ensures completeness and conformity with establishment policies and procedures

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Notifies supervisor when errors are detected; refers work to other workers for correction

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Compares corrected input and output data with source documents, worksheets, and data displayed on screen of computer terminal to verify corrections

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Prepares and maintains a system of logs and records of entries made

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• Separates source documents for distribution

• Sorts printouts for distribution

• Produces reports and printouts as needed

• Maintains security of the systems of records

• Assists and trains other staff on data entry processes

• Performs general office duties, i.e., answers phones, makes AllTran Financial - Collections Associate

Tulsa, OK • 07/2018 - 01/2019

C3 - Customer Service Representative

Tahlequah, OK • 10/2017 - 07/2018

copies, etc

• Assists clients and/or other staff as required

• Collect bankcard or retail credit accounts

• Negotiate payment arrangements

• Locate and contact consumers

• Effectively manage time, multi-task and prioritize

• Professionally document system with details

• Set goals, meet deadlines, work diligently

Resolve customer inquiries in a timely, professional and accurate manner

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Thoroughly and efficiently gather customer information, assess and fulfill customer needs and educate customers where applicable regarding products and services listed above

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Monitor desk backlog and file aging to ensure all inquiries are researched and responded to according to department guidelines

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Prepare an accurate & professional written response to the customer through e-mail or letter; some telephone contact required, as well

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• Ability to utilize and navigate multiple systems simultaneously

• Be dependable and meet all attendance requirements

• Meet or exceed company and client performance metrics Maintain a balance between company policy and client benefit in decision making

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Continuously evaluate and identify opportunities to drive process improvements that positively impact our client and its customers

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Responsible for call disposition, email correspondence or compiling and generating reports as required

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Ability to accept and embrace changes within the current business environment

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Contact this candidate