Authorization/ Pre certification/Admissions/ Patient Access Rep/ ICD-10 Desired Job Types:Full-timeContract Authorized to work in the US for any employer Works closely with health plans/payers and maintains strong business relationships. Provides appropriate issue resolution and/or escalation when needed. Works under moderate supervision, with clinical oversight. Reviews and adheres to all Company policies and procedures and the Employee Handbook. Participates in special projects and performs other duties as assigned. Possess excellent communication (verbal/written), organizational and interpersonal skills. Manages multiple tasks, detail oriented, responsive, and demonstrates independent thought and critical thinking. Participates in and contributes to performance improvement activities. Learn, understand and maintain working knowledge of products and services offered by the company. Accomplishments Accurate and complete data collection from referrals and completion of applicable paperwork. Interpret, verify and accurately enter data into computer to process orders. Answers telephone calls in a professional, friendly, helpful manner. Ensure patient qualifies for the type and quantity of product(s) ordered, based upon the patient's insurance and/or SMS contract guidelines. Obtain insurance authorization, when necessary. Promptly respond to and resolve customer issues.
Microsoft Office Applications (Word, Outlook, Excel) and Internet Explorer.
NCO financial Systems - Overland Park, KS April 2012 to June 2015 Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
Check to ensure that appropriate changes were made to resolve customers' problems.
Determine charges for services requested, collect deposits or payments, or arrange for billing.
Refer unresolved customer grievances to designated departments for further investigation.
Review insurance policy terms to determine whether a particular loss is covered by insurance.
Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
Resolve customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills.
Compare disputed merchandise with original requisitions and information from invoices and prepare invoices for returned goods.
Obtain and examine all relevant information to assess validity of complaints and to determine possible causes, such as extreme weather conditions that could increase bills.
Insurance Risk Assessor II Quest Diagnostics - Kansas City, MO March 2013 to February 2015 Responsibilities Answer incoming calls complete insurance applications in a timely manner.
Make outbound calls to applicants to complete underwriting process in a professional manner Accomplishments Most completed cases on team averaging 30+ cases per day promoted to interviewer II within 8 months of employment.
Medical Records ClerkMar 2016 to Current PrimeSource Healthcare － Leawood, KS
Creates new medical records and retrieves existing medical records by gathering appropriate record folders and contents; assigning and recording new record numbers; verifying existing record numbers; inputting and recording locations to computers Gathers patient information by collecting demographic information from a variety of sources; interacting with registration areas and physicians' offices; retrieving information from automated printer.
Maintains master patient index by completing assigned portion of daily audit trail; corrects and communicates problems according to established procedures.
Initiates the medical record by creating and processing the patient care record folder.
Maintains record availability by processing charts into the department; using chart mark-off procedures; facilitating chart location activities.
Retrieves medical records by following chart-out procedures; documenting reasons charts cannot be retrieved for statistical and follow-up purposes.
Delivers charts to assigned areas of the hospital by following established routing procedures.
Keeps health care providers informed by communicating availability or unavailability of the record.
Maintains quality results by following hospital standards.
Maintains continuity of work operations by documenting and communicating actions, irregularities, and continuing needs.
Maintains patient confidence by keeping patient records information confidential.
Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and jcaho standards.
Accomplishments Enhances medical records and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
Client Service RepresentativeApr 2015 to Jun 2015 Efinance － Overland Park, KS
Responsible for developing new business by making contact with customer application leads using telephone, email, and fax.
Evaluates loan applications based on lending company criteria and requirements which could include collecting and approving bank statements and pay stubs, verifying employment, and performing 3-way bank calls.
Clearly explains terms of customer loan contracts in their entirety.
Responsible for changing and updating customer information in operating systems.
Prevents customers from withdrawing their application by making special offers.
Identifies fraudulent applications using verbal or online confirmation of application information.
Accepts a minimum number of customer applications per day, based on tenure.
Averages a minimum number of calls per day, based on tenure.
Converts a minimum percentage of applications into a funded loan, percentage based on tenure.
Ensures compliance with all company and departmental policies, procedures, and guidelines.
AAS, Surgical Technology2012Anthem College － Kansas City, MOSurgical Technology
High School DiplomaMay 2000Lincoln College Prep kansas city － Kansas City, MO
10-key, Attention to Detail, charts, Excellent communication, interpersonal skills, contracts, critical thinking, detail oriented, email, fax, Focus, Internet Explorer, mark, Excel, Microsoft Office Applications, Outlook, Word, operating systems, organizational, patient care, policies, printer, Problem solving skills, Quality, recording, Reporting, routing, telephone, Time Management, typing, written