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Click here or scroll down to respond to this candidateOBJECTIVEMy primary objective is to bring consistency and dedication.Providing task attentiveness daily, conquering with a prepared plan.REFERENCESCandidate's Name
ADDRESS1461 Shade Creek Trail Forest Park, Ga30297PHONEPHONE NUMBER AVAILABLEEMAILEMAIL AVAILABLE EMAIL AVAILABLEEXPERIENCEMAR 2021 TO Mar 2024GRADY HOSPITAL PATIENT ACCESS ATLANTA, GA 30303Authenticate call on epic by verifying demographic, insurance.Proceed with scheduling financial counseling, primary care, specialty, med- subspecialty, Employee line, geriatric, toxicology, radiology and close with making sure Hospital Account Record. Closing with thank you on every call.Handled insurance verification and referrals for patients, ensuring accuracy and timeliness.Assisted in prior authorization of the patients.Managed prior authorizations and coordinated surgical schedules for patients.Handled Medicaid and Medicare processes for patients, ensuring compliance and coverage.Managed Explanation of Benefits (EOB) and conducted benefit verifications for patients.Verified patient benefits and coverage details with insurance companies.Managed medical claims processing and appeals, ensuring proper documentation and follow-up.Addressed escalated calls regarding insurance coverage issues, providing prompt and effective resolution.Conducted detailed calls with insurance companies to verify patient details and coverage.Managed a high volume of inbound and outbound calls, averaging 50+ calls daily,Reason of Gap: FamilyJAN 2016 TO DEC 2019NCO FINANCIAL SERVICE ATLANTA, GA 30322Key responsibility Authenticate call, collect demographic, verified insurance, enter data into computer, schedule /confirm appointments, follow guidelines for stat request, notify patients/physicians on correct authorization needed, properly respond to hearing impaired individuals, upload orders, review order making sure everything displayed, scanned orders, create health record numbers as needed, operate fax/copier machine and review precertification before patients appointments making sure in approved statues. Handled insurance verification and referrals for patients, ensuring accuracy and timeliness. Managed prior authorizations and coordinated surgical schedules for patients. Handled Medicaid and Medicare processes for patients, ensuring compliance and coverage. Managed Explanation of Benefits (EOB) and conducted benefit verifications for patients. Verified patient benefits and coverage details with insurance companies. Managed medical claims processing and appeals, ensuring proper documentation and follow-up. Addressed escalated calls regarding insurance coverage issues, providing prompt and effective resolution. Conducted detailed calls with insurance companies to verify patient details and coverage. Managed a high volume of inbound and outbound calls, averaging 50+ calls daily,Jan 2011 to Dec 2015HP Enterprise Georgia Medicaid Tucker, Ga 30384Authenticate Calls, provide statues of eligibility, copays, and benefit plan, reissue Medicaid cards, EDI password reset for medical members/billing agents, transfer calls as needed, review cpt codes, ICD 9 codes, HCPCS and modifiers, review provider contract, ub04 and HCFA1500 claim forms, provide statues of claim statues paid, denied or pending statues, reviewed provider contracts.Handled Insurance verification, prior authorization.Handled benefit verification of the patients.Jan 2003 to Dec 2010Tucker Pediatric Tucker, Ga 30384Schedule/Reschedule confirm appointments, verify insurance, numeric filing, charting, claim review billing, coding, collected co-pays, referrals, and be an advocate by reviewing explanations of benefits with patients. Leadership roles such as overseeingto patient balances after all collection efforts have been exhausted, Maintain positive relationships with families daily.EDUCATIONHSD Aug 2002Cornerstone christian academyTECHINICAL SKILLSEPIC, MICROSOFT WORD, EXCEL |
