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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Nunner RdMaineville, OH Street Address
PHONE NUMBER AVAILABLE EMAIL AVAILABLEOFFICE ADMINISTRATIONPatient Advocacy Physician Relationships Administrative Support First Point of Contact Database ManagementExperienced Office Administrator with outstanding customer service and administrative support experience. Successfully worked in a medical environment for 8 years starting in a Radiology Call Center Department., initializing authorization in a Claims Processing Department and working in a Pharmacy Home Delivery Services customer service environment. Key strengths in the following areas:Patient Advocacy / Support: Knowledgeable of medical terminology and processes. First point of contact for patients. Project and maintain clear, respectful and positive attitude.Records Management / Processing: Knowledgeable of complexities of Insurance claims processing and adjusting.Database Management: Skilled in data verification and entry.PROFESSIONAL EXPERIENCECINCINNATI EYE INSTITUTE (CEI) 2024Surgery Coordinator/Patient EducatorAbility to interact with patients and all levels of employees in a courteous, professional manner at all times.Knowledge of clinicProvide exceptional customer service during every patient encounter (in person or via phone)Schedule all surgeries and follow up appointment for the surgeonPractice urgency at all times with patients time, as well as doctors time and schedule, managing patient flowPatient Educator interfaces between patients who are interested in surgery and the medical, technical and administrative staff.Discuss cost and payment options including their intraocular lens options (ATIOL)Utilizes Electronic Health Records (EHR) system and all other software systems (Next Gen) in accordance with ECP protocols.MERCY/GROUP HEALTH ASSOC/PROLINK EMPLOYMENT SERVICES 2019 - 2023RegistrarThis position is responsible for answering, handling and screening incoming telephone calls, greeting and registering patients, filing and preparing charts. In addition, this position is responsible for check-out functions, including review on encounter form data, collection of co-payments, scheduling follow-up appointments, completing daily bank deposit, day-end reconciliation duties. Some locations also require this position to complete charge/receipt-entry and charge-receipt summaries for all office-related services.Demonstrates flexibility and/or initiative in seeking or accepting additional assessments.Schedules patient appointments. Informs department of issues.Accurately inputs patient registration information and updates patient insurance and demographic information.Accepts payments and logs appropriately.Demonstrates courtesy and respect toward families, community professionals and agencies, office personnel and team members. Follows JCAHO and HIPAA protocols; access to patient information will be limited to what is necessary to perform the job.Handles patient complaints and refers to manager as appropriate.Computer literate with knowledge of medical terminology.TRIHEALTH/GROUP HEALTH ASSOC/PROLINK EMPLOYMENT SERVICES 2018 - 2019Front Desk SpecialistThis position is responsible for answering, handling and screening incoming telephone calls, greeting and registering patients, filing and preparing charts. In addition, this position is responsible for check-out functions, including review on encounter form data, collection of co-payments, scheduling follow-up appointments, completing daily bank deposit, day-end reconciliation duties. Some locations also require this position to complete charge/receipt-entry and charge-receipt summaries for all office-related services.Demonstrates flexibility and/or initiative in seeking or accepting additional assessments.Schedules patient appointments. Informs department of issues.Accurately inputs patient registration information and updates patient insurance and demographic information.Accepts payments and logs appropriately.Demonstrates courtesy and respect toward families, community professionals and agencies, office personnel and team members. Follows JCAHO and HIPAA protocols; access to patient information will be limited to what is necessary to perform the job.Handles patient complaints and refers to manager as appropriate.Computer literate with knowledge of medical terminology.OHIO NATIONAL FINANCIAL SERVICES/AQUARIUS TEMPORARY AGENCY 2018Document Management Service clerkProcess intercompany mail for Institutional/Annuity investments and Life Insurance. Put information into intercompany software products: AWD, NBAFile intercompany mailHelp with indexing, faxing and NBA/AWD data entry.Mail out correspondence ie: Fed Ex, UPS and 1st class mail.Open emails from Lotus NotesCopy appropriate paperwork for mailings.Assist associates to meet mail deadlines.WELLPOINT (ANTHEM BLUE CROSS /BLUE SHIELD), Mason, OH 2013 2017Claims Representative I, IIProcessed and adjusted health claims in accordance with policies and procedures with 100% accuracy. Responded to written inquires and initiated steps to assist patients regarding issues related to the content or interpretation of benefits, policies and procedures. Gained knowledge of medical terminology.Processed hospital and professional claims for payment electronically.Ensured all information was accurate before eligible payments were made.Researched and analyzed claims issues within company guidelines.Investigated CPT/procedure codes, HCPCS, modifiers and ICD-9/ICD-10 diagnosis codes.EXPRESS SCRIPTS PHARMACY, Mason, OH 2011 2013Physician-Patient Advocate / PrepperTook Inbound/Outbound calls from patients/medical facilities and faxed prescribers to obtain prescriptions on behalf of patients who agreed to use Home Delivery. Effectively managed a case load of records to facilitate timely processing of Home Delivery prescription requests.Obtained doctor office verbal approvals for new prescriptions and/or refills submitted for processing. Processed electronic prescriptions from Medical Doctor Offices (MDO) and attached to patients account according to their policy insurance plan for approval/denials/pended cases for accurate shipment and billing processing.Under general direction, answered questions related to pharmacy Home Delivery benefits, while maintaining productivity standards and quality metrics.Worked independently to resolve patient or physician inquiries in a timely and efficient manner.Demonstrated ability to manage difficult customer situations and escalate when necessary.Determined next steps for escalated issues. Adapted to change and met changing demands of a dynamic work environment.AEROTEK, Mason, OH 2010 2011UMR Utility Management Representative (Assignment: Wellpoint/Anthem Blue Cross/Blue Shield)Assisted the Non-Clinical Support Team with calling out determinations on approvals and denials, obtaining discharge dates, requesting additional information and monitoring task lists to ensure cases were reviewed timely.Made call outs to facilities with authorizations for medical inpatient/outpatient visits.Assisted the Non-Clinical Support team with calling out determinations on approvals and denials, obtaining discharge dates, requesting additional information and monitoring task lists to ensure cases are reviewed timely.Developed and maintained positive customer relations and coordinates with various functions within the company to ensure customer requests and questions were handled appropriately and in a timely manner.Responded to telephone and written inquiries from clients, providers and in-house departments.WELLPOINT (ANTHEM BLUE CROSS /BLUE SHIELD), Mason, OH 2005 2010Claims Representative I, IIProcessed and adjusted health claims in accordance with policies and procedures with 100% accuracy. Responded to written inquires and initiates steps to assist patients with issues relating to content or interpretation of benefits, policies and procedures.Specialized in coordination of benefits (COB) and Medicare parts A and B policies.Processed 18 claims per hour with 100% accuracy.Invited to participate in a special pilot task force team for COB/coordination of benefits claims. Team was responsible for developing and implementing new procedures for increased efficiency and accuracy.Initiated intakes to Certificate Analysts coordinators to provide correct information of primary, secondary and tertiary policies for accurate payouts.Promoted to Claims Representative II and qualified for work at home program.Radiology UMR Utility Management RepresentativeEvaluated queries in a call center environment. Processed new patients preauthorization for radiology treatments. Investigated and processed 120 calls per day with 100% accuracy.Maintained clear, respectful and positive attitude toward patients at all times.Ensured all calls had positive outcomes and assisted in escalations appropriately.Demonstrated research and analytical skills found issues with system and procedures and brought them to the attention of Operation Lead Experts.Independently performed assigned tasks with minimal supervision or guidance.PREVIOUS EXPERIENCEAssembler, TRIM PARTS INC., Lebanon, OHOffice Manager / Administrative Assistant, ALS HEATING AND COOLING INC., Mason, OHReceptionist / Applications Assistant, CUSTOM COASTERS, West Chester, OHInventory Clerk / Receptionist, BAE SYSTEMS, Mason, OHEDUCATIONAdministrative Assistant TrainingSCARLET OAKS VOCATIONAL SCHOOL, Sharonville, OHGraduate (General Business)LITTLE MIAMI HIGH SCHOOL, Morrow, OH |
