Financial Clearance Representative Resume Example
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FINANCIAL CLEARANCE REPRESENTATIVE
Professional Summary
Organized multi-tasker effectively managing multiple projects simultaneously in a fast-paced environment.
Skills
Knowledge of Medicare and medi-cal/Medicaid plans
Knowledge of HMO, PPO, EPO, and POS plans
Trained new Employees within Sutter shared services, and Coram
Was nominated to represent the EOW committee with Sutter Shared
services for the year 2014 to 2015.
Experience in Salesfource, EPIC, Legacy, E-care Passport
programs.
Experience in Value Stream mapping and LIEN.
Licenses
Certifications / Licenses
Health Care Assistant, Category A
IATA, Shipment of Hazardous Goods
CPR
Human Participant Protections
education for research
Cultural competency
NIH stroke scale certification
Skill Highlights
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Professional Experience
Financial Clearance Representative
August 2014 to CurrentFairview Health Services － Woodbury , MN Financial Clearance Team Member - Patient Access Center - Sutter Shared Services � Serves as the pre-service point of contact for patients to obtain all necessary information to pre-register and financially clear patients prior to day of service delivery. Also handles non-clinical referrals and authorization coordination and unbilled account follow-up. Enhances the patient experience throughout all patient interactions by serving as the customer service point of contact by demonstrating knowledge of Sutter's Health system and service offerings. Work with Pediatric, Bariatric, and Labor & Delivery registration departments.
August 2014 to CurrentFairview Health Services － Woodbury , MN Financial Clearance Team Member - Patient Access Center - Sutter Shared Services � Serves as the pre-service point of contact for patients to obtain all necessary information to pre-register and financially clear patients prior to day of service delivery. Also handles non-clinical referrals and authorization coordination and unbilled account follow-up. Enhances the patient experience throughout all patient interactions by serving as the customer service point of contact by demonstrating knowledge of Sutter's Health system and service offerings. Work with Pediatric, Bariatric, and Labor & Delivery registration departments.
Customer service Insurance Specialist
September 2012 to August 2014Gm Financial － Morristown , NJ Contact Insurance companies for patients that are going to be getting Home infusion therapy. Verifying patient's deductibles, out of pocket coverage and co pays for services. Making sure all Insurance Verification forms are completed properly for audits. Making sure to have the proper HCPC codes for what medications patients will be receiving. Work with HCN, and Legacy program for patients' medical records, and payers. Work with several branches, and authorization specialist. Work with Outlook, Excel, word Documents, sales force, and PDF. Knowledge of several states insurance plans.
September 2012 to August 2014Gm Financial － Morristown , NJ Contact Insurance companies for patients that are going to be getting Home infusion therapy. Verifying patient's deductibles, out of pocket coverage and co pays for services. Making sure all Insurance Verification forms are completed properly for audits. Making sure to have the proper HCPC codes for what medications patients will be receiving. Work with HCN, and Legacy program for patients' medical records, and payers. Work with several branches, and authorization specialist. Work with Outlook, Excel, word Documents, sales force, and PDF. Knowledge of several states insurance plans.
Medical Assistant in Podiatrics
March 2009 to May 2012Nuvance Health － Brewster , NY Assist With three Podiatric Specialists. Room patients, did blood draws when needed, and help with surgical procedures. Return patient phone calls, set up appointments, did authorizations for surgical procedures or other medical necessities. Maintain and Organize Doctor's schedule at all times. Scheduled meetings with other associates, and Pharmaceutical Representatives on a monthly basis. Maintain Patients charts, called in prescriptions when needed. Did pre-op assessments with patients who are scheduled for surgery Managed surgery scheduling for the physicians. Did post-operative care with patients Draw up injections for the Podiatrist per request Specialize in orthotic education and durable medical equipment. Did authorizations and referrals for some procedures and medication. Some casting experience Left job position due to husband received a job transfer
March 2009 to May 2012Nuvance Health － Brewster , NY Assist With three Podiatric Specialists. Room patients, did blood draws when needed, and help with surgical procedures. Return patient phone calls, set up appointments, did authorizations for surgical procedures or other medical necessities. Maintain and Organize Doctor's schedule at all times. Scheduled meetings with other associates, and Pharmaceutical Representatives on a monthly basis. Maintain Patients charts, called in prescriptions when needed. Did pre-op assessments with patients who are scheduled for surgery Managed surgery scheduling for the physicians. Did post-operative care with patients Draw up injections for the Podiatrist per request Specialize in orthotic education and durable medical equipment. Did authorizations and referrals for some procedures and medication. Some casting experience Left job position due to husband received a job transfer
Clinical Research Coordinator
September 2007 to November 2008Nuvance Health － New Windsor , NY Assist with investigational study selection, including site/sponsor correspondence, regulatory document preparations for protocol, informed consent and appropriate HIPAA inclusions for IRB submission-ongoing. Management of study review process according to site/sponsor/IRB guidelines.Coordinate the daily activities for several research studies, including electrophysiology and pharmaceutical research; Responsibilities include new study preparation, subject screening, recruitment and enrollment, informed consent process, preparation for study monitor visits. Handling test article (TA) as directed by the investigator, maintaining drug accountability, completing and ensuring the quality of case report forms, reconcile data query / clarification forms. Maintain source documents, electronic medical records, and ensuring site quality. Manage subject visits, including obtaining vital signs, adverse events and administering TA. Conduct staff in-services prior to implementation of new research trials. Working knowledge of regulations, including the Food and Drug Administration (FDA), Good Clinical Practices (GCP's), International Conference on Harmonization (ICH), and Health Insurance Portability and Accountability Act (HIPAA), institutional policies and procedures. Maintain regulatory documentation for several research studies, which include receiving approval prior to enrolling subjects, corresponding with the IRB on safety reporting, study modifications, closure to accrual reports and annual reviews; maintaining regulatory files/binders, Maintain screening logs. Marketing experience. Event coordinator for special events to promote the institute. Perform other duties as required by management. Was laid off due to economy
September 2007 to November 2008Nuvance Health － New Windsor , NY Assist with investigational study selection, including site/sponsor correspondence, regulatory document preparations for protocol, informed consent and appropriate HIPAA inclusions for IRB submission-ongoing. Management of study review process according to site/sponsor/IRB guidelines.Coordinate the daily activities for several research studies, including electrophysiology and pharmaceutical research; Responsibilities include new study preparation, subject screening, recruitment and enrollment, informed consent process, preparation for study monitor visits. Handling test article (TA) as directed by the investigator, maintaining drug accountability, completing and ensuring the quality of case report forms, reconcile data query / clarification forms. Maintain source documents, electronic medical records, and ensuring site quality. Manage subject visits, including obtaining vital signs, adverse events and administering TA. Conduct staff in-services prior to implementation of new research trials. Working knowledge of regulations, including the Food and Drug Administration (FDA), Good Clinical Practices (GCP's), International Conference on Harmonization (ICH), and Health Insurance Portability and Accountability Act (HIPAA), institutional policies and procedures. Maintain regulatory documentation for several research studies, which include receiving approval prior to enrolling subjects, corresponding with the IRB on safety reporting, study modifications, closure to accrual reports and annual reviews; maintaining regulatory files/binders, Maintain screening logs. Marketing experience. Event coordinator for special events to promote the institute. Perform other duties as required by management. Was laid off due to economy
Clinical Research Coordinator
July 2005 to August 2007Dcs Corporation － Alexandria , VAConducted psychology clinical research studies for patients with Alzheimer's, insomnia, General Anxiety, Depression, and Attention Deficit Disorder. Managed studies from phases II-IV Trials in all aspects of the study start-up such as advertising, patient recruitment, screening, scheduling, creating source documents, maintaining regulatory records, collecting patient medical history. Worked with electronic medical records, gathered psychiatric history, concomitant medication information, handling of test article, calculating patient compliance, SAE reporting, Query resolution, IRB correspondence, and study close-out visits.Conducted patient follow-up visits, including vitals, ECG, phlebotomy, specimen processing for ambient and dry ice shipments, drug test, and injections.Liaison between site and sponsor regarding study specific issues.Marketing experience Event coordinator for special events to promote the institute.Other duties as required.Leftjob position because moved out of state.
July 2005 to August 2007Dcs Corporation － Alexandria , VAConducted psychology clinical research studies for patients with Alzheimer's, insomnia, General Anxiety, Depression, and Attention Deficit Disorder. Managed studies from phases II-IV Trials in all aspects of the study start-up such as advertising, patient recruitment, screening, scheduling, creating source documents, maintaining regulatory records, collecting patient medical history. Worked with electronic medical records, gathered psychiatric history, concomitant medication information, handling of test article, calculating patient compliance, SAE reporting, Query resolution, IRB correspondence, and study close-out visits.Conducted patient follow-up visits, including vitals, ECG, phlebotomy, specimen processing for ambient and dry ice shipments, drug test, and injections.Liaison between site and sponsor regarding study specific issues.Marketing experience Event coordinator for special events to promote the institute.Other duties as required.Leftjob position because moved out of state.
Office Manager
January 2002 to August 2005Amsurg Corp. － Toms River , NJ Established and managed a well organized, smoothly operated, and efficient Internal Medicine-Nephrology Specialist practice. Did all authorizations and referrals' contacted insurance companies when needed.Left position had moved out of area.
January 2002 to August 2005Amsurg Corp. － Toms River , NJ Established and managed a well organized, smoothly operated, and efficient Internal Medicine-Nephrology Specialist practice. Did all authorizations and referrals' contacted insurance companies when needed.Left position had moved out of area.
Office Assistant
September 1999 to January 2002Children's Medical Clinic － City , STATE Answered phones, maintained patients charts, scheduled appointments as well as maintained Physicians schedule and Calendar. Helped assist Medical Assistance when needed for back up. Insurance verification, Copay collections and outstanding payments.
September 1999 to January 2002Children's Medical Clinic － City , STATE Answered phones, maintained patients charts, scheduled appointments as well as maintained Physicians schedule and Calendar. Helped assist Medical Assistance when needed for back up. Insurance verification, Copay collections and outstanding payments.
Office Assistant/ Medical Assistant
May 1998 to July 1999North Creek Medicine － City , STATE Front and Back office duties.Maintained medical records.Worked on various types of software systems.Lab assistant.ECG technician.Did insurance Referrals' and authorizations when needed. Left job position tomove to California for college.
May 1998 to July 1999North Creek Medicine － City , STATE Front and Back office duties.Maintained medical records.Worked on various types of software systems.Lab assistant.ECG technician.Did insurance Referrals' and authorizations when needed. Left job position tomove to California for college.
Office assistant/ Medical Assistant
July 1995 to April 1998Alameda Medical Group － City , STATE Internal Medicine Physicians Medical Assistant.Obtained patient vital, blood draws, and ECG's.Handled chief complaints.Worked with pharmacies for Medication Prior Authorization / Refill Requests.Maintained patient records. Worked with several types of computer and software programs. Was lead insurance authorization and referral specialist. Left job position moved out of state to take care of a family member.
July 1995 to April 1998Alameda Medical Group － City , STATE Internal Medicine Physicians Medical Assistant.Obtained patient vital, blood draws, and ECG's.Handled chief complaints.Worked with pharmacies for Medication Prior Authorization / Refill Requests.Maintained patient records. Worked with several types of computer and software programs. Was lead insurance authorization and referral specialist. Left job position moved out of state to take care of a family member.
Clinical Research Coordinator/ Office assistant
July 1993 to July 1995Bernard M Sklar M.D. Inc － City , STATE Practiced protocol medicine with emphasis on patient health history.Assisted in managing up to 12 Phase II-IV trials including study start-up, study advertisement, patient recruitment, phone screening potential patients, maintaining regulatory binders, study drug documentation, CRF completion, Adverse Event reporting, medical history, concomitant medication, SAE reporting, Query resolution, study close-out, and IRB correspondence.Phlebotomy, processing laboratory specimens such as gram stains, Hematology slides, urine specimens, ECG's, and Pulmonary Function Tests.Doctor merged practice with Alameda Medical Group did not leave position.
July 1993 to July 1995Bernard M Sklar M.D. Inc － City , STATE Practiced protocol medicine with emphasis on patient health history.Assisted in managing up to 12 Phase II-IV trials including study start-up, study advertisement, patient recruitment, phone screening potential patients, maintaining regulatory binders, study drug documentation, CRF completion, Adverse Event reporting, medical history, concomitant medication, SAE reporting, Query resolution, study close-out, and IRB correspondence.Phlebotomy, processing laboratory specimens such as gram stains, Hematology slides, urine specimens, ECG's, and Pulmonary Function Tests.Doctor merged practice with Alameda Medical Group did not leave position.
Education and Training
Associate of Science : Micro Computer operations and Business , 2001MTI Business and Technology － City, State, USA
Micro-computer operations skills
such as Microsoft word, Excel, outlook,
Business
skills, and managerial training
Certification A.S.P.T : Phlebotomy/ECG Technician , 1995Phlebotomy Plus － City, State, USA Phlebotomy Plus,
A.S.P.T. and ECG Certification
Certification of Transcription : Medical Trancription and General Courses Alameda College － City, State, USA
Professional Organization
ACRP – Association of Clinical
Research Professionals
NIH- National Institute of Health
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Resume Overview
School Attended
- MTI Business and Technology
- Phlebotomy Plus
- Alameda College
Job Titles Held:
- Financial Clearance Representative
- Customer service Insurance Specialist
- Medical Assistant in Podiatrics
- Clinical Research Coordinator
- Office Manager
- Office Assistant
- Office Assistant/ Medical Assistant
- Office assistant/ Medical Assistant
- Clinical Research Coordinator/ Office assistant
Degrees
- Associate of Science : Micro Computer operations and Business , 2001
Certification A.S.P.T : Phlebotomy/ECG Technician , 1995
Certification of Transcription : Medical Trancription and General Courses
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