Financial Clearance Specialist, 04/2014
to Current
Children's National – Silver Spring,
MD
Dedicated to completing patient access workflows related to improve financial outcomes to decrease first pass denials and increase point of service collections. Cleared over 600 Radiology and Surgery
accounts each month with an average of $900,000
in saved revenue for the facility. Use quality auditing and reporting tools to identify denial issues and trends by staff members, clinical area, payer, and provider. Work directly with Business Operations, Managed Care and other departments on identified process improvements. Provide training and education to managers and staff to obtain sustainable improvements in areas of opportunity.
Ambulatory Services Scheduling Liaison, 04/2013
to 04/2014
Children's National – Washington,
DC
Register and schedule patients' appointments by telephone utilizing the physician scheduler and individual departmental guidelines. Provide patient services and administrative support in clinic operations. Interact with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy.
Reimbursement Associate/ Clinical Operations Representative, 11/2010
to 04/2013
Children's National – Washington,
DC
Provide patient services and administrative support in clinic operations. Interacts with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. Ensure registration data integrity.
Financial Counselor, 03/2008
to 02/2010
Suburban Hospital – Bethesda,
MD
Communicated with insurance companies to
determine appropriate benefits, required co-pay, and pre-authorization
requirements for services being rendered to accurately secure proper
reimbursement from insurance companies and patients. Obtained approval for surgical, radiology, and
physical therapy procedures using the appropriate ICD-9 and CPT codes . Entered all necessary pre-authorization
requirements into the computer management system to ensure correct transfer of
information for billing purposes. Acted as a liaison between the
patient/guarantor, insurance company, and physician office to ensure all
necessary approvals for services rendered and received are obtained and
documented appropriately. Resolved financial issues of patient accounts by
reviewing a daily report of services rendered to verify benefit and
pre-authorization details and update information as needed.
Patient Access Representative II, 10/2000
to 02/2008
Children's National – Washington,
DC
Completed emergency room and inpatient computer
aided online registrations using Star Navigator. Admitted and discharged patients by updating
Star Navigator upon arrival to or departure from assigned unit. Obtained approval for inpatient admissions in a
timely manner, Resolved financial issues of patient accounts by
verifying demographic and insurance information to ensure appropriate
reimbursement. Cooperated with other departments to meet the
institutional objectives in terms of patient and account flow. Interacted regularly with parents, physicians,
and patients. Entered data, filed records, and answered a
multi-line phone for the Admissions Department.
