Alicia Williams
Benbrook
Summary
I am a self-motivated, energetic individual with over 10 years of experience in the healthcare/medical insurance industry. I have navigated the ever changing insurance field with ease and have enjoyed being challenged to sustain the high standards that patients and families deserve.
Overview
21
21
years of professional experience
Work History
Account Specialist 1
Cook Children's Physician Network
07.2022 - Current
- Analyzed medical claims for accuracy and compliance with company policies and regulatory standards.
- Implemented process improvements that reduced claim turnaround time and increased efficiency.
- Verified patient insurance coverage and benefits for medical claims.
- Monitored and updated claims status in claims processing system.
- Researched and resolved complex medical claims issues to support timely processing.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Followed up on denied claims to verify timely patient payment and resolution.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Patient Account Representative II (Orthotics/Prosthetics)
Cook Children's Home Health
05.2013 - Current
- Process intakes from beginning to end
- Obtain orders from physician's offices
- Verify patient benefits and consult with them about copays/amounts that will be due prior to receiving orthotic devices
- Obtain insurance authorizations
- Work closely with practitioners to make sure we are ordering exactly what the patient needs
- Work patient schedules weekly and have delivery paperwork ready prior to their appointments.
- Answer phone calls/Faxes/Scan paperwork
- Claim follow up and appeals
Reimbursement PSC
Cook Children's Home Health
05.2011 - Current
- Obtaining all Medicaid authorizations for DME
- Work closely with all department to ensure accuracy of authorizations to ensure payment.
- Obtain all Medicaid forms related to DME
- Very familiar with insurance guidelines (Medicaid and Commercial)
- Work with physician offices/patients to ensure paperwork is being obtained correctly
Patient Service Coordinator I
Cook Children's Home Health
05.2010 - Current
- Worked directly with patients to ensure they got their medical supplies in a timely manner
- Answered questions about supplies/Insurance benefits
- Verified eligibility
- Obtained authorizations for DME/Skilled Nursing
- Worked hold files/PAR reports/CMN reports
- Resolved customer complaints and issues to drive satisfaction and loyalty.
- Communicated with clients and service providers to provide updates on work progress.
Medical Records Tech
Cook Children's Home Health
08.2008 - Current
- Managed patient health records, ensuring compliance with HIPAA regulations.
- Coordinated data entry processes for accurate medical documentation and retrieval.
- Expedited release-of-information requests by verifying authorization forms and providing requested documents promptly.
- Kept accurate log of requests for medical information and records.
- Maintained patient records in compliance with security regulations.
- Reviewed charts and flagged incomplete or inaccurate information.
Radiology Records Tech
Tri-City Hospital
06.2004 - 06.2006
- Assisted doctors and patients with various tasks related to the Radiology department
- Phones, Faxes, Filing, Organizing, Copying
- Transported films/files throughout hospital and various facilities
- Front Desk- Scheduling, Checking patients in/out
- Updated records with new information.
- Transferred inactive records to storage to free up space and preserve history.
- Followed up with medical staff regarding missing information in patient records.
- Assisted in preparation of medical reports for external parties.
Education
Associate of Applied Science - Healthcare Information Technology
Hutchinson Community College
Hutchinson, KS05-2022
High School Diploma - undefined
Pacific View Charter School
Oceanside, California05.2004
Skills
- Insurance Precertification/Authorization: Advanced
- Reviewing benefit and eligibility information: Advanced
- Customer service with patients and providers: Advanced
- Claim follow up and appeals: Advanced
- Intake and Referral processing: Advanced
- Familiar with HCPC and ICD-10 Coding: Advanced
- Able to multitask and maintain a professional attitude under pressure: Advanced
- Excellent communication
- Teamwork and collaboration
- Problem-solving abilities
- Adaptability and flexibility
Timeline
Account Specialist 1
Cook Children's Physician Network
07.2022 - Current
Patient Account Representative II (Orthotics/Prosthetics)
Cook Children's Home Health
05.2013 - Current
Reimbursement PSC
Cook Children's Home Health
05.2011 - Current
Patient Service Coordinator I
Cook Children's Home Health
05.2010 - Current
Medical Records Tech
Cook Children's Home Health
08.2008 - Current
Radiology Records Tech
Tri-City Hospital
06.2004 - 06.2006
High School Diploma - undefined
Pacific View Charter School
Associate of Applied Science - Healthcare Information Technology
Hutchinson Community College
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