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Click here or scroll down to respond to this candidateCandidate's Name
Chicago, IL Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEWork ExperiencePatient Billing Contact CenterAdvocate Health Care-Oak Brook, ILJune 2017 to PresentAddresses and resolves patient inquiries regarding billing, collections, insurance, payment and other issues related to hospital bills. Provides information, responds to questions, identifies appropriate opportunities to collect payment for services that have been provided. Serves as an advocate for the patient and family members when dealing with problem accounts. Provides efficient, courteous and expert customer service to all patients, insurance carriers, doctor offices and all other third parties in relation to hospital account inquiries. Assures that confidentiality/HIPAA guidelines are followed. Daily contact with patients or family members, insurance companies/managed care organizations, physicians and their billing services, third party payers, ambulance companies, hospital personnel, Health Information Management, ancillary departments and Registration areas. Internal written and verbal communications: Patient Financial Services associates and other departments. External written and verbal communications: Patients/Guarantors, Other Billing Offices, Doctors, Auditors, Outsource Agencies, Attorneys, Insurances and other Advocate facilities. Receipt of appropriate authorization from patient to release bills/records in accordance with HIPAA requirements. Determines when to debit/ credit a patient bill. Determines when an account should be held on A/R or in an agency. Determines when an audit should be performed. Determines when a problem should be referred to the supervisor for handling. High volume of patient contact over the phone regarding a variety topics. Access to patient files containing confidential medical and financial information Must meet department KPI's and Guiding Principals High volume, fast paced office environment Referral SpecialistInfinity Healthcare Management-Hillside, ILJanuary 2020 to December 2020Verify payor source for all residents to ensure that payment will be forthcoming.Research all available systems to confirm resident source of payment. Ensure timely response for resident referral,Validate resident eligibility. Confirm updated authorizations for Managed Care B in clinical systems. Post authorization in system for billing. Confirm payment amount due for consolidated billing by checking CMS portal for fee schedules and after coding provide bill to A/P for submission of payment. Other duties as assignedPatient Access Partner IILoyola University Medical Center-Maywood, ILFebruary 2015 to June 2017ResponsibilitiesAnswers phones to provide assistance to patients and physicians requesting referrals and appointments. Pre-registers patients for appointments and tests, verifies and updates patient demographic and insurance information. Establishes and maintains ongoing partnerships with designated clinical partners to ensure achievement of aligned goals.CADENCE APPOINTMENT SCHEDULING TRANSACTIONS Utilizes scheduling software to perform a variety of actions including scheduling, canceling or rescheduling appointments. QUALITY & ONGOING TRAINING: Demonstrates a commitment to quality improvement and excellence. EPIC REGISTRATION Accurately pre-registers patients for appointments and tests. MANAGED CARE Understands and identifies insurance types. Clinic Partner- Works with designated clinical partners and dynamic schedulers to establish and maintain appropriate appointment scheduling protocols. Claim Service RepresentativeNorth America Medical Management-Hillside, ILApril 2014 to December 2015ResponsibilitiesRespond to member/provider/agent/broker inquiries via telephone regarding health insurance benefits, eligibility and claims. Analyze problems and provide correct information and solutions. Communicate monthly messages to providers on a specific needs basis. Changing demographic for members as well as changing PCP's. Given provider and health insurance company the claim status, pay out, repricing, and etc.Comprehensive understanding of contents of the medical record, medical terminology and abbreviations, ICD9/ICD10 coding conventions and guidelines and proper code capture.Processing claims on Ezcap/net software.Central Registrar Outpatient RegistrationAnn and Robert Lurie Children Hospital-Chicago, IL September 2013 to April 2014ResponsibilitiesRegisters patients for future appointments. Obtains accurate demographic and insurance information. Performs eligibility and benefit verification for ambulatory patients. Completes timely and accurate pre- registration. Responds to inquiries regarding services at Children's Hospital of Chicago Medical Center.Obtains all demographic and financial information by interviewing parents via telephone or in person to create and complete registration process. Accurately creates and updates registration data for patients. Answers phones, responds to general questions regarding services available at the medical center, the satellite sites, health insurance, gives directions to various sites, and documents appropriate data for each call in the database. Verifies insurance eligibility prior to the patient visit. Identifies need for insurance authorization or referral and instructs family to obtain insurance authorizations for service when needed.CSR-ChicagoMaximus-ILApril 2012 to September 2013ResponsibilitiesRespond to AHCT Call Center inquiries and complaints received by telephone, IVR, and web portal using applicable reference materials from the Knowledge Management System (KMS), Frequently Asked Questions, and other online resources to provide information as appropriate to resolve inquiries and complaints. Retrieve, review, verify, collect, record, or update customer contact information and data through the CRM.Assess customer inquiries and screen complaints to determine the correct course of action.Educate callers about theAffordable Care Act, AHCT eligibility screening, application, inquiry, complaints, claims, exemptions, appeals and enrollment procedures, including Medicaid program benefits and policies. Call Center RepresentativeGoHealth Insurances-Chicago, ILMay 2011 to April 2013ResponsibilitiesDemonstrated excellent verbal and telephone skills. Provided excellent customer service and creating a comfortable environment. Ability to a team lead, as well as a team player in a fast pace environment. Experience in office Microsoft.Client Specialist/Administrative AssistantExhibitor's Carpet Service-Chicago, ILApril 2011 to April 2012Placing carpet orders for the tradeshow industryHeavy client interaction, order input, order maintenance.Respond to customer's issues, inquires via telephone and email, to quickly resolve customer's issues Administrative AssistantYMCA Garfield-Chicago, ILJune 2007 to March 2012Responsible for completing, performing clerical, receptionist and operational duties. Key accountabilities, including answering the phone system, management of all office supplies, mail and mailing, assistance with office events and meeting planning.Work independently, work well with a team and abilities to handler and prioritize.Head Cashier/ Customer Service/ Call Center RepHome Depot-Chicago, ILOctober 2004 to November 2007Answer incoming calls from customers to take orders, answer inquiries and questions, handle complaints and provide information.Answer 150 calls per dayRinging on the registerCall Center Rep/ Customer ServiceFEMA/Apple-Chicago, ILSeptember 2002 to March 2005Answering phones to respond to applicants, general customer inquiries, and customer complaints. Project a professional company image through phone interaction. Transfer customers to the apropriate departments.Identify, research, and resolve customer issues using the computer system. EducationA.A. in Business ManagementTaylor Business Institute Chicago - Chicago, ILJanuary 2011 to December 2013Skills CSR Call Center Customer Care Customer Service Medical Billing Medical Records Managed Care Insurance Verification Epic Medical Office Experience CPT Coding Medical Scheduling FMLA ICD-9 ICD-10 EMR Systems IVR Microsoft Word Computer skills Microsoft Excel Typing Medical terminology Communication skills Medical coding Clerical experience EMR systems ICD-9 Epic ICD-10 HIPAA Hospital experience Customer service Front desk Windows Proofreading Cash register Phone etiquette Time management Office experience Knowledge management Leadership |
