Adrienne Holeman
Tempe,United States
Summary
Been in the healthcare industry for 20 + years, from hands on patient care to administration work.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Financial Counselor/Authorization Specialist
Oncology Convergence, Inc.
Tempe, United States
04.2023 - Current
- Obtain pre-authorization from insurance carriers for medical services within a designated time frame
- Follow up and secure prior-authorizations prior to service appointments
- Demonstrate proficiency in medical terminology and general medical office procedures, including HIPAA regulations
- Maintain a productive work rate suitable for the department
- Record all communication with providers and personnel in standardized documentation with the proper format
- Review denial reasons and advocate for patients while obtaining approval/denial letters, informing the office of results, and providing appeal services
- Build relationships with physician offices and clinics by initiating contact via email, answering phone/email correspondence promptly, and responding within one business day
- Coordinates the collection of patient/guarantor co-pays, co-insurance, deductibles or open balances
- Monitor duties, company's processes and reports deviations to Client Service Manager
- Responsible for Insurance verification, authorizations and cost of treatments
- Counsels patient or guarantor regarding financial matters before and during treatment
- Responsible for maintaining updated patient information (AOB, HIPAA, insurance, etc.) in the practice management system
- Advises patient/guarantor of third party benefits and estimates the amount they are responsible to pay
- Counsels patients needing financial assistance
- May refer patient/guarantor to obtain co-pay assistance, drug replacement, outside financing in order to meet financial obligations
- Responds to financial inquiries from the patient/guarantor about their treatment or account
- Maintain appropriate documents, reports and files in order to comply with all applicable laws and policies
- Other duties as assigned by your supervisor
- Experience with Availty, OneHealthport, Medicare, Medicaid, Evicore, Carelon and many other portals
- I work with iKnowMed, OncoEMR, eClinicalWorks, G4, Unlimited Financials, Centricity
Benefits Specialist
CVS Health
Chandler, United States
08.2021 - 03.2023
- I was responsible to verify insurance coverage, perform benefit investigation, and obtain prior authorization for both new and existing patients in order to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers
- This role will required me to have an understanding of insurance carriers and concepts including drug cards, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs
Patient Service Rep TL
Triwest Healthcare Alliance
Tempe, United States
07.2015 - 03.2021
- Patient Service Rep who maintains a high level of professionalism, patience, and efficiency to minimize customer dissatisfaction and increase customer loyalty
- Assist in managing phone coverage, completing call audits as well as attending weekly meetings and calibrations
- Proficient in Microsoft Word, power point, excel, One Note
- Outlook email, x-trax browser, coding ICD9-10, medical terminology, Triwest intranet, internet
- Promoted from CAS member, to CAS TL then PSR TL
- Completed monthly call audits on PSRs has monthly job duties required
- Answers inquiries by clarifying desired information; researching, locating, and providing information
- Resolves problems by clarifying issues; researching and exploring answers and alternative solutions; implementing solutions; escalating unresolved problems
- Management of team chats in the work from home environment.
Clinical Assistant
Hawaii Pacific Health
Honolulu, United States
10.2012 - 10.2014
- Worked closely with nurses and medical staff to ensure that patients are provided basic care on a daily basis
- Some of these duties include bathing, feeding and dressing patients
- Also made beds and took note of any changes in the physical or emotional state of the patient depending on their case
- Assist patients with getting out of bed and walking when needed, as per MD requests
- Responsible for vital signs, such as respiration rate, temperature and blood pressure
- Also, obtained blood sugar levels as needed
- As a clinical assistant, I performed many functions within Hawaii Pacific Health System
- Such as scheduling specialty appointments to accommodate the patients release from the hospital
- Arranging for any tests that needed to be complete following hospital care
- My primary function being a CA was to support Patient, nurse care team, and doctors
- I utilized my interpersonal skills to effectively understand patient's needs, assess possible courses of action and take appropriate measures to ensure patient satisfaction
- Acting as a patient advocate to the nurse/MD by attempting to resolve patient needs to the best of my ability within my designated role, per protocol
Medical Assistant
Hawaii Pacific Health
Honolulu, United States
02.2012 - 10.2012
- Schedules patients for intake assessments;
- Collect and abstract medical records for patients, from previously seen doctors
- Took medical history, baseline assessments and tests for interpretation by the MD
- Maintained accurate chart notes in electronic medical record
- Assisted physician with examinations, treatments and procedures; reports any adverse reaction and symptoms to MD or Charge Nurse; assisted and instructed patients on procedures and tests or treatments; maintain a clean work environment with disposing of contaminated and disposable items;
- Request-receive and review medical summaries and test results from prior doctors; maintain and arrange medical records; control and scan health and administrative information such as insurance cards, ID, and prior tests; maintain and arrange follow up appointments; and also, served as a coordinator of incoming and outbound telephone calls, receiving a wide range of inquiries, utilizing administrative systems knowledge to identify patient/caller needs, practicing independent decision making, coordinating care needs, scheduling appointments, and directing problem resolution as appropriate
- Determined the nature of the call and assisted with communicating needs regarding appointments, medication refills/renewals/tracking and referring the call to the appropriate clinic as needed or administrative personnel to solve matters, utilized computer technology to ensure continuity of care through accurate patient information, communication and documentation
Shift Supervisor
Starbucks
Honolulu, United States
07.2011 - 02.2012
- As a Starbucks Shift Supervisor, I assisted the store manager in executing store operations during scheduled shifts
- As a team lead, I deployed partners and delegated tasks to create the Starbucks Experience for our customers by providing legendary customer service with prompt service, quality beverages and products, and maintained a clean and comfortable store environment
- I was responsible for modeling and acting in accordance with Starbucks guiding principles and was part of a company that is consistently rated as a great place to work and the people here love what they do
- Responsibilities and essential job functions included:
- Acted with integrity, honesty and knowledge that promote the culture, values and mission of Starbucks
- Maintained a calm demeanor during periods of high volume or unusual events to keep store operating to standard and to set a positive example for the shift team
- Anticipated customer and store needs by constantly evaluating environment and customers for cues
- Assisted with new partner training by positively reinforcing successful performance and giving respectful and encouraging coaching as needed
- Provided feedback to store manager on partner performance during shift
- Contributed to positive team environment by recognizing alarms or changes in partner morale and performance and communicating them to the store manager
- Created a positive learning environment by providing clear, specific, timely and respectful coaching and feedback to partners on shift to ensure operational excellence and to improve partner performance
- Delivered legendary customer service to all customers by acting with a customer comes first attitude and connecting with the customer
- Discovered and responded to customer needs
- Developed positive relationships with shift team by understanding and addressing individual motivation, need and concerns
- Executed store operations during scheduled shifts
- Organized opening and closing duties as assigned
- Followed Starbucks operational policies and procedures, including those for cash handling and safety and security, to ensure the safety of all partners during each shift
- Followed all cash management and cash register policies and ensures proper cash management practices were followed by shift team
- Followed up with baristas during the shift to ensure the delivery of legendary customer service for all customers
- Maintained regular and consistent attendance and punctuality
- Provided quality beverages, whole bean, and food products consistently for all customers by adhering to all recipe and presentation standards
- Followed health, safety and sanitation guidelines for all products
- Recognized and reinforced individual and team accomplishments by using existing organizational tools and by collaborating with store manager to find new, creative, and effective methods of recognition
- Utilized operational tools to achieve operational excellence during the shift
Education
Certificate -
Bryman College
Seatac12.2001
Technical or Occupational Certificate -
Northland Pioneer College
Winslow, AZ09.1999
High school diploma or GED -
College Degree in Medical Assisting -
Skills
- Computer software skills
- Drug Screens
- EKG
- Phlebotomy
- Phone Triage
- X-Ray Tech
- Lab Assistant
- Referrals
- Coding office visits and procedures
- Staff scheduling
- Vital signs
- Reporting abnormal test results
- Preparing patients for examinations, treatments, procedures
- Pre-filled out consent forms
- Performed EKG's
- Recorded all tests
- Received and reviewed all incoming information
- Rearranging physician's schedule
- Maintained paperless medical records
- Completed insurance claim forms
- Knowledge of computer software with experience in inputting and extracting data from database
- Assisting in disrobing
- Gowning
- Draping
- Assisted with instruments
- Dressings
- Medication
- Biological specimens
- ICD-10
- Medical Scheduling
- Venipuncture
- Special Education
- Laboratory Procedures
- Intake Experience
- EMR Systems
- Dialysis Experience
- Epic
- Insurance Verification
- Office Administration
- ICD-10
- Teaching
- Microsoft Dynamics GP
- Case Management
- Patient Care
- Medical Billing
- CPT Coding
- QuickBooks
- Experience Administering Injections
- Medical Terminology
- Medical Coding
- ICD Coding
- Transcription
- Accounting
- Microsoft Powerpoint
Certification
- AHA Certification, 01/2000
- Certified Medical Assistant, 01/2000
- BLS Certification, 01/2000
Assessments
- Supervisory skills: Motivating & assessing employees, Proficient, 07/2021
- Attention to detail, Proficient, 03/2023
- Caregiver fit, Proficient, 03/2023
- Management & leadership skills: Impact & influence, Proficient, 07/2021
.
.
Timeline
Financial Counselor/Authorization Specialist
Oncology Convergence, Inc.
04.2023 - Current
Benefits Specialist
CVS Health
08.2021 - 03.2023
Patient Service Rep TL
Triwest Healthcare Alliance
07.2015 - 03.2021
Clinical Assistant
Hawaii Pacific Health
10.2012 - 10.2014
Medical Assistant
Hawaii Pacific Health
02.2012 - 10.2012
Shift Supervisor
Starbucks
07.2011 - 02.2012
Certificate -
Bryman College
Technical or Occupational Certificate -
Northland Pioneer College