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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Elkton DriveRaleigh, NC Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLECase Manager/CMA with over 28 years of healthcare experience in the medical field. I look forward toworking with the public assisting patients and their loved ones by offering to work on their behalfadvocating for them to understand as well as receive the best healthcare experience they deserve,especially when you're struggling with long term illnesses. Im attentive, and detail oriented, a teamplayer that is always willing and ready to step in and assist others.Im a licensed Administrator in the State of North Carolina, A Certified Medication Technician since2011. I have years of experience in both administrative duties, Diagnostic Imaging, MedicationAuthorizations and Appeals/ Per-certificationsEDUCATION:Wilby High School - Graduated 1986 Business Administration569 Bucks Hill Rd Waterbury, CT 06704Excel Academy- 837 Whalley Avenue New Haven, CT 06515Certified Nursing Assistant Graduated -1998Branford Hall Career Institute-35 North Main Street Southington, CT 06489Associate Degree- Certified Medical AssistantGraduated September 2002Strayer University 3421 Olympia Drive Raleigh, NC 27610Bachelor's Degree- Healthcare Administration 2019PROFESSIONAL EXPERIENCE:Aston Carter Agency/ Mercalis-Case ManagerDec-2023-Current Employer Facilitate communication between health insurance, claims adjuster, providers. Coordinate care between healthcare providers and pharmacies Utilization review Obtain precertification Follow up with patients/guardians to see if they have any concerns or questions on the medication savingsprogram. Benefits Investigation-verify the status of coverage before services are rendered. Appeal denied claims on behalf of the patient.Raleigh Radiology-Patient Care CoordinatorFeb 2021- November 2023Assist patients calling directly to schedule in-house radiology appointments, approvals/denials.Greet incoming patients arriving for their appointment.Verify proper ID and health insurance on every patient upon arrival.Make sure there's an order from a physician for the patient's appointment.Verify that authorizations are approved prior to the patient's appointment. Schedule follow-upappointmentsCollect deductibles and copays at the Time of service.Financial Care Counselor- DukeNov 2017-2019Resolve insurance claim edits for rejections and denials.Make daily cash deposits.Obtain and verify authorizations based on certain insurances.Facilitate payment sources for uninsured patients.Explain policies and coverage as required.Schedule all incoming new referrals for Intramuscular injections.Duke University HospitalOctober 5, 2005-2017Record & update patient information into Maestro Care database, as well as manage appointment schedulingand follow up.Phlebotomist for patients that were on weekly Anticoagulants.Verified authorizations for prescribed medications on behalf of patients with their insurance providers.Assist Primary care Doctor with annual physicals, EKGs and scheduling diagnostic imaging.Edit and update insurance information prior to the patient's appointment in Epic.CERTIFICATIONS:Certified Medical Assistant 2002Medication Technician 2008DHHS Licensed Administrator (State of North Carolina) 2022Skills:Salesforce Health Cloud PlatformMicrosoft 360 Office SuiteEPICProficient Exchange EMRHIPAA GuidelinesRapid Rebate |
