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patient access lead financial counselor resume example with 14+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Professional Summary

Driven and compassionate healthcare professional with seven years hands-on experience in fast-paced residential and hospital environments. Accountable and responsible with a strong focus on patient wellness.

Education and Training
Certification in Medical Office Assistant: Health Care, Expected in 2002
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American School of Technology - Columbus, OH
GPA: GPA: 4.0
Status -

Minor in Medical Billing and Coding

4.0 GPA

Select One: Business Administration, Expected in 1996
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Columbus State Community College - Columbus, OH
GPA:
Status -

Coursework in Business

High School Diploma: , Expected in 1989
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Independence High School - Columbus, OH
GPA:
Status -

Completion of required courses and electives

Skill Highlights
  • Staffing management ability
  • Patient-oriented
  • Relationship and team building
  • Staff training and development
  • Proven patience and self-discipline
  • Personal and professional integrity
  • Sound decision making
  • Critical thinking proficiency
Professional Experience
Patient Access Lead/Financial Counselor, 2013 - Current
Maine Health Damariscotta, ME,
  • Effective communication skills Manages excellent interpersonal skills that are necessary when dealing with peers, internal, and external Accuracy, attentiveness to detail and time management skills Over five years' experience working with Medicaid and Medicare rules and regulations Three years' experience working with Integrated HealthCare Information System (IHIS) registering and scheduling patients timely Two years' experience in people management Facilitate and assist in all new hire training of all financial aid processes Verify Performs activities related to registration and financial clearance for multiple patient types Assists in implementing processes to monitor and measure staff performance and develop mechanisms to ensure accurate and quality work Create guidelines and implemented strategies to enhance the Medical Center's process improvement processes Participates in and fosters a performance improvement approach that includes both intradepartmental and interdepartmental activities.
  • Responsible for compliance with Organizational Integrity through raising questions and promptly reporting actual or potential wrongdoing.
  • Excellent problem solving strategies, responding to customer service issues and complaints and resolve or escalate them appropriately Proactively communicates with all staff members of all upcoming changes in an accurate and timely manner.
  • Assist with sponsorship leadership and ongoing education to all access staff Helps oversee deposit collection process Assist Financial Counselor help patients complete Medicaid Expansion applications.
Oncology Financial Services Counselor, 2009 - 2013
The James Cancer Hospital City, STATE,
  • Worked non-insured high dollar accounts by obtaining third party payer sources utilizing county and federal funding.
  • Verified HCAP and Medicaid eligibility for all self-pay patients at bedside Efficient in CAPI- Patient Management and Patient Accounting Capable of navigating through the E Results system Confirm HCAP applications are in the imaging system Maintained and managed James Medicaid spend down revenue was refunded to the hospital timely Conducted in-services with social workers and PCRM's to insure knowledge of Medicaid processes were being following appropriately Initializing Nursing Home placements with Patient Care Resource Managers and Social Workers Cross-trained co-workers on job functions Trained new hires on all departmental job duties (in-patient, outpatient, and registration) Assisted with registration functions when needed.
Pre-Certification Representative, 2007 - 2009
James Cancer Hospital City, STATE,
  • Provide professional, accurate, timely insurance verification and notification for outpatient diagnostic services, observation and inpatient services.
  • Ensure all account activity is documented in the computer system timely and thoroughly Utilized payer websites and documentation to determine determine if the scheduled service is medically necessary based on payer guidelines by CMS and commercial payers Working knowledge of Medical Necessity protocols for scheduled tests and procedures and notifies physician office of any tests that do not meet necessity guidelines Communicates and educates patients and physician practices to ensure compliance with identified payer requirements as needed Validates that all necessary referrals, pre-certification and/or authorizations for scheduled service are on file and that they are valid for the scheduled test being performed Calculates patient estimated portions via estimation tool and contacts patient prior to the scheduled appointment to notify patient of their patient responsibility Notify Benefit Verification Manager immediately when uninsured or underinsured patients are identified Responsible for maintaining performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met Used complex problem solving skills, relied on other departments to complete needed clinical information submission to payers Maintained all departmental standards for productivity, QA, rejections, and ill time use Demonstrated excellent team behaviors Served as liaison between insurance company, physicians, specialists, patients, and other OSUMC hospital personnel Responded to patient questions in a way conducive to patient satisfaction Resolved routine customer service issues in a timely manner and to the satisfaction of physicians, patients and payers.
  • Completed daily reports assuring all insurance information is accurate and up to date in SMS system, all verification is completed and all precertification is complete.
Skills

IHIS

Resolute/Prelude

Word, Excel, Access

Microsoft Outlook

Project Planning

Case Management

Leadership Skills

Strategic Thinking

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Resume Overview

School Attended

  • American School of Technology
  • Columbus State Community College
  • Independence High School

Job Titles Held:

  • Patient Access Lead/Financial Counselor
  • Oncology Financial Services Counselor
  • Pre-Certification Representative

Degrees

  • Certification in Medical Office Assistant
  • Select One
  • High School Diploma

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