Albertha Carter
Whitsett,NC
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
26
26
years of professional experience
Work History
Financial Care Counselor
Duke University Health System
Durham, NC
01.2023 - Current
- Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage.
- Implement appropriate collect cash payments appropriately for all patients.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Cash Manager and Cash management.
- Daily Reconciliation of clinic Deposits/Charge Fund
- Providing excellent customer service by promptly answering patient inquiries.
- Answered communications telephone, email and web chat.
- Manage Edit Claims in work queue system
- Skilled at working independently and collaboratively in team environment.
- Usage of budget tools, educational support and referrals for clients.
- Schedule patients Appointment.
- Perform those duties necessary to ensure all accounts are processed accurately and efficiently.
- Explain bills provides assistance to visitors and patients.
- Update billing system to reflect insurance status of patient.
- Check patients in with accurate patient demographic and financial data.
- Obtain all Prior Authorization Certification and/or authorizations as appropriate.
- Calculate and according to PRMO credit and collection policies.
- Answered over 25 customer communications per day via telephone, email and web chat.
Behavioral Health Technician
Duke University Hospital
Durham, NC
01.2020 - 12.2022
- Improved patient outcomes by implementing evidence-based behavioral interventions and strategies.
- Provided crisis intervention services, successfully de-escalating situations and ensuring patient safety.
- Enhanced patient engagement in their treatment plan through active listening and empathetic communication skills. Administer treatment and personal care procedures to patients including, but not limited to, feeding, bathing, shaving changing clothing, cleaning, and trimming fingernails, bed-making, assisting with ambulation, enemas, skin care, and bowel and bladder elimination; provide such additional care as required to meet personal needs and comfort of assigned patients.
- Clean assigned area: stock and replenish supplies and equipment as required.
- Delivered compassionate care under challenging circumstances, consistently demonstrating resilience and adaptability when faced with unexpected obstacles or setbacks in patient progress.
- Built and maintained positive staff relationships to promote teamwork and better serve clients.
- Conducted client rounds to check on residents.
- Recognized individuals under influence of drugs or alcohol and typical behaviors associated with each.
- Participate in transport of patients.
- Perform variety of clerical tasks involved in operating organization's patient care information system.
- Assign nursing staff to communication systems. Perform other related duties incidental to work described herein.
Behavioral Health Technician
UNC Health Care
Chapel Hill, NC
01.2012 - 11.2020
- Participated in multidisciplinary team meetings to discuss progress and treatment plans of clients.
- Escorted patients from unit to meals, activities, and visitation areas to maintain standard of safety and security.
- Performed client intake procedures according to internal standards for new admissions.
- Conducted client rounds to check on residents.
- Assisted with patient restraint and seclusion scenarios to create safe environment for patient and medical personnel.
- Facilitated group therapy sessions to help clients develop coping strategies and social skills.
- Administer treatment and personal care procedures to patients including, but not limited to, feeding, bathing, shaving changing clothing, cleaning, and trimming fingernails, bed-making, assisting with ambulation, enemas, skin care, and bowel and bladder elimination; provide such additional care as required to meet personal needs and comfort of assigned patients.
- Applied de-escalation and limit-setting techniques to promote patient cooperation.
- Perform variety of clerical tasks involved in operating organization's patient care information system.
- Developed and maintained positive relationships with clients to create safe and supportive environment.
- Retrieve and record patient data in electronic medical records (EMR) and report to Nurse noting any new abnormal changes in patient's condition.
Healthcare Assistant
Murdoch Developmental Center
Butner, NC
01.2010 - 01.2012
- Assisted with patient hygiene, physical comfort, eating, and drinking, and mobility while observing and reporting specific changes.
- Followed directions of licensed nurses to administer medications and treatments.
- Changed linens in rooms, keeping spaces fresh and clean for patient health and satisfaction.
- Supervised patients on commodes, in toilets, and bathrooms and assisted patients with hygiene needs.
- Lifted patients using appropriate equipment in accordance with moving and handling policy.
- Communicated effectively with patients and families to provide information about care and treatment.
- Maintained clean environment with due consideration to health and safety issues and infection control policy.
- Aided patients with walking and limb exercises to improve strength and balance.
- Helped patients with self-feeding and assisted feeding, based on individual needs.
- Facilitated personal hygiene management, and ambulation.
Quality Analyst
Aetna
Hartford, CT
06.2008 - 11.2010
- Corrected CPT codes to properly classify EOB claims.
- Excellent written & verbal communication skills.
- Examined claims forms and other records to determine insurance coverage.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Administered 100 -150 internal quality audits and assessed results to inform corrective action measures.
- Analyzed quality and performance data to support operational decision-making.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies Identifies, accesses and prioritizes sources of data that are relevant to particular issues.
- Conduct reviews/audits to evaluate completing with standards and outcomes (e.g. quality, accuracy and timeliness).
- Maintain focus on quality in completing internal processes correctly and efficiently.
- Good analytical skills and proficiency with MS Word, Excel and PowerPoint.
- Knowledge of Medicare and Medicaid billing rules required.
- Performing daily audits of coding team and sending audit report on daily basis.
- Good Knowledge of medical terminology.
- Maintain current knowledge of policies and guidelines related to documentation, coding, billing, revenue cycle, as assigned, and other professional integrity topics.
- Translate claim details into constructive data.
- Research providers contracts to assure correct payments on claims.
Medication Technician
Greensboro Manor
Greensboro, NC
01.2007 - 12.2008
- Improved medication administration accuracy by meticulously following physician orders and verifying patient information.
- Enhanced patient safety through diligent monitoring for adverse drug reactions and promptly reporting concerns to nursing staff.
- Maintained up-to-date knowledge of medication protocols, resulting in efficient dispensing and accurate documentation.
- Streamlined medication storage and inventory processes, ensuring timely reordering and minimizing waste.
- Reduced medication errors by implementing double-check system before administering medications to patients.
- Assisted in training new Medication Technicians on best practices and company policies, fostering culture of continuous learning.
- Maintained thorough electronic records of all administered medications, adhering to HIPAA regulations and facility guidelines.
- Reviewed patient progress to document effects of any prescribed medication.
- Helped patients complete range of motion exercises to prevent loss of function during care.
- Reduced risks of patient infection and cross-contamination by cleaning and sterilizing equipment.
- Administered psychotropic medications and anxiety education to patients to provide mental health care.
- Supported needs of 36 + residents under long-term care.
Medical Billing Specialist
Lighthouse MD
Providence, RI
09.2006 - 08.2008
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
- Increased overall efficiency of billing department by regularly auditing internal procedures and suggesting improvements.
- Posted and adjusted payments from insurance companies.
- Prepared billing correspondence and maintained database to organize billing information.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in timely manner.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in revenue cycle.
- Manage patients account and invoice.
- Performing administrative tasks such as answering phone calls and responding to emails.
- Ensuring that patient records, accounts, and payments are meticulously handled.
- Following work procedures methodically while ensuring compliance with rules and regulations of hospital or clinic as well as state and federal laws.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Audited and corrected billing and posting documents for accuracy.
Customer Service Representative
Apria Healthcare
High Point, NC
10.2006 - 06.2007
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Streamlined call center processes for improved efficiency and reduced wait times.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Interact with patients and referrals through various communication channels.
- Receive and process order requests for medical equipment and services.
- Provide accurate information and updates on orders.
- Demonstrate professionalism and provide high-quality service to patients and referrals.
- Resolve patient and referral complaints and escalations with urgency.
Support Specialist
The May Institute
Randolph, MA
05.2001 - 08.2006
- Improved customer satisfaction by addressing and resolving technical issues swiftly and efficiently.
- Streamlined support procedures for quicker response times, resulting in higher client retention rates.
- Collaborated with cross-functional teams to develop and implement effective support strategies.
- Enhanced user experience by providing comprehensive troubleshooting guidance for various software and hardware systems.
- Generated reports to track performance and analyze trends.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Developed strong relationships with clients, resulting in repeat business and positive feedback.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Provided primary customer support to internal and external customers.
- Updated account information to maintain customer records.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Developed customer service policies and procedures to meet and exceed industry service standards.
Cashier Assistant
Eastside Market
East Providence, RI
02.1998 - 08.2005
- Enhanced customer satisfaction by providing efficient and accurate checkout services.
- Reduced wait times for customers by quickly processing transactions and maintaining organized work area.
- Maintained clean and safe workspace, ensuring proper sanitation protocols were followed.
- Assisted with restocking shelves and inventory management to keep store well-stocked and appealing to customers.
- Provided exceptional customer service, addressing customer inquiries and resolving issues promptly.
- Supported store operations by assisting with tasks such as cleaning spills, organizing displays, or retrieving carts when necessary.
- Cleaned and sanitized cashier workstation and scanning area.
- Met customer needs through polite, friendly and attentive service.
- Helped customers complete purchases, locate items, and join reward programs.
- Trained new cashier team members in customer service and money handling processes.
- Answered questions about store policies and addressed customer concerns.
- Retrieved items for customers and verified prices.
- Packed customer orders into boxes and bags, transferring to shopping cart.
- Bagged items securely to minimize breakages and reduce losses.
- Learned duties for various positions and provided backup at key times.
- Checked personal identifications during alcohol and tobacco sales.
- Operated cash register to record transactions accurately and efficiently.
- Performed cash, card and check transactions to complete customer purchases.
- Demonstrated flexibility by working various shifts including weekends, holidays or evenings when required.
- Handled cash drawer responsibly, accurately counting change and ensuring daily balances were correct.
- Trained new cashier assistants in company policies, procedures, and best practices for optimal performance.
Education
Certificate - Health Claims Specialist
The Salter School
Fall River, MA05.2005
High School Diploma -
School One
Providence, RI06.1997
Skills
- Excellent customer service skills
- Pro-active problem-solving skills
- Insurance Company Knowledge
- Demographics Information
- Insurance Verification
- Ability to manage challenging situations and conversations
- Assisting customers with professionalism
- Medical Terminology
- Cash Flow Management
- Knowledge of Excel and Microsoft office
- Organizational Skills
- Teamwork and Collaboration
Timeline
Financial Care Counselor
Duke University Health System
01.2023 - Current
Behavioral Health Technician
Duke University Hospital
01.2020 - 12.2022
Behavioral Health Technician
UNC Health Care
01.2012 - 11.2020
Healthcare Assistant
Murdoch Developmental Center
01.2010 - 01.2012
Quality Analyst
Aetna
06.2008 - 11.2010
Medication Technician
Greensboro Manor
01.2007 - 12.2008
Customer Service Representative
Apria Healthcare
10.2006 - 06.2007
Medical Billing Specialist
Lighthouse MD
09.2006 - 08.2008
Support Specialist
The May Institute
05.2001 - 08.2006
Cashier Assistant
Eastside Market
02.1998 - 08.2005
Certificate - Health Claims Specialist
The Salter School
High School Diploma -
School One