LiveCareer-Resume

patient access representative financial counselor resume example with 11+ years of experience

JC J S S JS J S S JS J S S JS J S S JS J S S JS J S S JS
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary

Dedicated Healthcare Professional skilled in technical, clerical, and patient support. Strong ability to communicate clearly and effectively to both patients and staff. Licenses CPR certified through American Heart Association to 2018 Certified Nursing Assistant, 2011 to 2023

Skills
  • Collaboration Skills
  • Insurance Verification
  • Documented Success in Financial Counseling
  • Increase Health Safety Management
  • Process Improvement
  • Communication Skills
  • Team-Player
Work History
12/2021 to 08/2022 Clinical Administrative Coordinator Hospital Sisters Health System - Corporate | Mattoon, IL,
  • Initial triage of members for possible transition to clinical staff
  • Managing admission and discharge census information
  • Serving as a point of contact for facilities and clinical teams, telephonic engagement with members and providers, providing information on available network services
  • Managing the referral process to connect members with all available resources,
  • Management of prior authorizations, and generation of written determination notifications.
  • National Letter Team Letter Coordinator is responsible for drafting Notice of Action (NOA) and Notice of Extension (NOE) letters for government and commercial specific clients that adhere to the state and federal regulatory requirements.
  • The Letter Coordinator also completes outbound calls to client-specific customers requesting the return of specific letters.
  • Communicated with patients in both English and Spanish, providing translation services where needed
03/2020 to 09/2021 Patient Access Representative/Financial Counselor HonorHealth Hosptial | City, STATE,
  • Participated in continuous improvement by generating suggestions, engaging in problem-solving activities to support teamwork.
  • Delivered exceptional level of service to each customer by listening to concerns and answering questions.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Processing incoming and outgoing referrals and prior authorizations
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
  • Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
  • Managed over 50 calls per day and 90 accounts high volume hospital/clinic/facility
10/2018 to 02/2020 Financial Counselor Kaiser Permanente | City, STATE,
  • Verifies patients’ insurance coverage, eligibility, and Point of Service financial obligation for all scheduled services, and documents the system in detail. Adheres to all third party payer requirements for both government and commercial payers.
  • Determines insurance eligibility and coverage, obtains/confirms authorization to avoid non-compliance and penalties to patients, health system and physician.
  • Communicates current Medicare requirements, HIPAA compliance and reimbursement criteria.
  • Collaborates with Case Management to ensure patient status is correct and documentation is provided to insurances as needed.
  • Creates and/or updates hospital account. Obtains and enters into hospital information system required patient demographics and insurance information in a timely manner after procedure is scheduled.
  • Documents all information according to departmental guidelines. Provides feedback to supervisor on changes/updates implemented by insurances as obtained.
  • Contacts patients to verify demographic information and to perform financial counseling prior to time of service. Collects patient responsibility due, provides information on payment plans and financial assistance as necessary.
  • Ensures that an account is established for every scheduled patient. Obtains complete and accurate patient demographics, insurance plan and benefits information, and ensures treatment authorization is secured in advance of the scheduled procedure while maintaining a minimum accuracy rate on reviewed accounts
  • Contacted insurance companies for patient medical billing operations.
  • Boosted productivity by 5% and exceeded daily target by employing consultative sales tactics and superior customer care
04/2017 to 10/2018 Surgery Scheduling Coordinator/CSR Northside Hospital | City, STATE,
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Entered orders into the EMR system efficiently and without errors.
  • Compiled necessary documents for surgical billing packages.
  • Determined prior authorizations for medication and outpatient procedures.
  • Posted and adjusted payments from insurance companies.
  • Accurately posted and sent out all medical claims.
  • Accurately posted surgeries, hospital visits and payments for assigned carriers.
  • Confidently and adeptly handled claim denials and/or appeals.
  • Maintained strict patient and physician confidentiality.
  • Submitted electronic/paper claims documentation for timely filing.
  • Verified patients' eligibility and claims status with insurance agencies.
  • Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.
  • Improved ED administration by compiling and analyzing data and identifying areas of improvement.
  • Collected blood, tissue and other laboratory specimens and prepared them for lab testing.
  • ICD- 9 and ICD- 10 trained.
  • Communicated effectively with staff, patients and insurance companies by email and telephone.
  • Verified insurance coverage and obtained pre-authorizations.
  • Answered phone calls and messages for medical facility, scheduling pre & post -op appointments and handling patient inquiries.
06/2010 to 03/2017 Clinical Care Coordinator II Company Name | City, State,
  • Obtain and record vital signs on mother/baby, intake/output amounts, or other measures in medical record (McKesson) as designated.
  • Assist mothers with breastfeeding, provides patient education relating to infant and self-care.
  • Assist nurse/doctors with labs and surgical procedures.
  • Collect blood specimen from mother/baby for blood glucose & various other lab tests.
  • Transports patients, equipment, and specimens throughout the hospital.
  • Provides customer service support to patients, guests, and staff by answering telephones, taking messages, routing calls to appropriate individual(s), greeting new admissions, conducting customer service rounds, and assist with service recovery.
  • When appropriate, answers customer's questions and provides requested information as necessary.
  • Provides customer service support to patients, guests, and staff by providing directions, paging requested individual(s), and distributing and collecting appropriate paperwork and forms as necessary.
  • Maintains patient records and transcribes physician orders as necessary.
  • Maintains patient census and patient identification information in computer system.
  • Orders and maintains appropriate inventory of unit supplies.
  • Performs quality control audits of electronic medical records.
  • Coaches and trains new associates in appropriate clerical and or clinical duties.
  • Enter data into computer system for billing.
  • Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
  • Prepared billing correspondence and maintained database to organize billing information.
Education
Expected in 2017 to to Associate of Science | Nursing Gwinnett Technical College, Lawrenceville, GA GPA:

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Your data is safe with us

Any information uploaded, such as a resume, or input by the user is owned solely by the user, not LiveCareer. For further information, please visit our Terms of Use.

Resume Overview

School Attended

  • Gwinnett Technical College

Job Titles Held:

  • Clinical Administrative Coordinator
  • Patient Access Representative/Financial Counselor
  • Financial Counselor
  • Surgery Scheduling Coordinator/CSR
  • Clinical Care Coordinator II

Degrees

  • Associate of Science

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in:As seen in: