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lead patient access representative resume example with 9+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Experienced healthcare worker with a diversity of skills from medical records and clinical to front office, billing, lead and current hospital worker. I bring professionalism and integrity along with advance skills in Epic and insurance knowledge. Strong communication skills with leadership experience and ability. Excellent at conflict resolution and improving patient satisfaction. Ready to bring over 20 years of healthcare experience and humbly embrace all there is to learn in a new position.


Skills
  • Insurance Verification
  • Medical terminology
  • Payment collection/posting of payments
  • Verbal and written communication
  • Quality assurance
  • Proficient in MS, Epic and One Source
  • Emergency room
  • Leadership
  • Grievance handling
  • Labor negotiation
  • Policy interpretation
  • Contract administration
  • Organization and Time Management
  • Hospital Operations
  • Benefits explanation
  • Analytical and Critical Thinking
  • Staff education and training
  • Medical coding knowledge
  • Medicare and medicaid rules and regulations
  • Patient Information Collection
  • Authorizations
  • Critical Thinking
  • Good Telephone Etiquette
Work History
08/2018 to Current Lead Patient Access Representative Amita Health | Milwaukee, WI,


  • Improved and implemented process changes to minimize recurring patient issues and complaints.
  • supports business leaders through consistent communication and administrative support duties.
  • Recognized Claims edit issues prior to denials and applied appropriate data for effective resolution. Which result in low number of claim denials.
  • Managed multiple projects simultaneously using organizational and analytical skills.
  • Assessed Workques and Audited employee errors. Followed by coaching and team building through encouragement and communication operational plans to uphold quality standards.
  • Fostered excellence example by "setting pace" and being a hands on mentor to staff.
  • Direct day-to-day administrative and operational functions for 144-bed facility, providing guidance and leadership across multiple departments.
  • Identified operational issues, analyzed information and provided solutions to problems through critical thinking and problem solving techniques resulting in zero escalations.
  • Works effectively with staff from all departments to coordinate resolutions
07/2012 to 08/2018 Patient Access Representative Methodist Hospital For Surgery | Westerville, OH,
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Performed as initial contact for patients scheduling their imaging and lab services followed up with registration then directing patient to appropriate department.
  • Performed patient pre-admission, admission, transfer and discharge activities.
  • Ran estimates on experian one source passport Reviewed and determined patient co-insurance, deductible and co-pay amounts. Collected and discussed options to satisfy remainder of patient financial obligations.
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered..
  • Obtained signatures from financial responsibility and treatment procedures from patients or guarantors.
  • Assisted patients in understanding individual rights and responsibilities in regards to care, coverage and payment.
  • Recommended service improvements to minimize recurring patient issues and complaints.
01/2011 to 06/2011 Clinical Data Abstractor Allina Health Systems | Edina, MN,
  • Performed regular quality and validation assessments on patient data to verify accuracy.
  • Collected, organized and entered patient data into medical systems.

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  • Used Software to code and categorize health information for analysis and insurance reimbursement purposes.
  • Researched and validated clinical data.
  • Consulted professional standards of care, scientific evidence and practice to evaluate health care programs.
  • Completed timely abstraction to maintain compliance with registry deadlines.
  • Reviewed medical records to abstract information according to definition of various registries.
  • Compiled electronic patient records covering conditions, treatments and diagnoses.
  • Input data into computer programs and filing systems.
  • Maintained accuracy, completeness and security for medical records and health information.
  • Handled high-volume data entry of demographics, disease etiology and extent and associated procedures or treatments.
  • Utilized Software to manage and confirm patient data, such as insurance, demographic and medical history information.
  • Followed exact procedures for handling transfers and other releases of medical records.
  • Compiled, abstracted and coded patient data using classification manuals and standard systems.
  • Maintained historical reference by abstracting and coding clinical data such as diseases, operations, procedures and therapies with standard classification systems.
  • Reviewed charts and flagged incomplete or inaccurate information.
  • Uploaded physician progress notes, history and physicals into electronic medical records.
  • Used classification manuals to gain additional knowledge of disease and diagnoses processes.
Education
Expected in to to Certificate | Medical Billing And Coding Carrington College California - Sacramento, Sacramento, CA GPA:
Expected in to to Certificate | Clinical Medical Assistant Boston Reed, Pittsburg, CA, GPA:
Accomplishments
  • Achieved A 99.8 % RQA score by completing clean registrations with accuracy and efficiency.
  • Recognized as a top collector
  • Promoted into leadership positions
  • Supervised team of 3- 15 staff members.
Certifications
  • Notary Signing Agent, 2018
  • Liveecan fingerprint roller. State of Ca Department Of Justice - 2019

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Resume Overview

School Attended

  • Carrington College California - Sacramento
  • Boston Reed

Job Titles Held:

  • Lead Patient Access Representative
  • Patient Access Representative
  • Clinical Data Abstractor

Degrees

  • Certificate
  • Certificate

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