Alma Simmons
Charlotte,NC
Summary
Results-driven Insurance Verification Specialist with a strong background at IBM, specializing in benefits coverage assessment and patient communication. Demonstrated success in expediting verifications and boosting patient satisfaction. Proficient in data analysis and compliance management, ensuring efficient operations in high-pressure healthcare settings.
Overview
15
15
years of professional experience
Work History
Insurance Verification Specialist
International Business Machines (IBM)
Charlotte, NC
02.2023 - Current
- Facilitated timely verification of insurance benefits and financial clearance.
- Verified and obtained required referral, authorization, or pre-certification before services were provided.
- Obtained patient data information to facilitate verification.
- Maintained expert-level knowledge of available verification and eligibility tools.
- Communicated with patients, physicians and internal hospital personnel regarding insurance benefits information.
Insurance Verification Specialist
Atrium Health
Charlotte, NC
10.2021 - 02.2022
- Facilitated timely verification of insurance benefits and financial clearance.
- Verified and obtained required referral, authorization, or pre-certification prior to services being provided.
- Communicated with patients, physicians and internal hospital personnel regarding insurance benefits information.
- Obtained patient data information to facilitate verification.
- Documented verifications and payment details in the electronic medical records systems.
- Compiled medical reports covering specific patient or general office data.
- Transmitted medical records and correspondence on behalf of patients and practitioners.
- Corresponded with insurance companies to process claims of patients.
- Updated patient medical records with direct intake information and transcribed practitioner messages.
Medical Unit Clerk
Augusta University Medical Center
Augusta, GA
10.2019 - 10.2021
- Facilitated and processed billing statements and invoices.
- Scheduled patient appointments in EMR system.
- Compiled medical reports covering specific patient or general office data.
- Coordinated patient appointments and hospital admissions.
- Maintained privacy and confidentiality of patients in compliance with policies and regulations.
- Updated patient medical records with direct intake information and transcribed practitioner messages.
- Greeted patients and visitors to determine needs and direct accordingly.
- Transmitted medical records and correspondence on behalf of patients and practitioners.
- Managed registration desk by answering telephones and transferring calls to designated department.
- Scheduled x-rays and lab work for patients.
Insurance Verification Specialist
Novant Healthcare
Charlotte, NC
01.2011 - 12.2016
- Verified and obtained required referral, authorization, or pre-certification prior to services being provided.
- Facilitated timely verification of insurance benefits and financial clearance.
- Documented verifications and payment details in Epic EMR system.
- Fostered regular communication and follow-up with patients and families.
- Communicated with patients, physicians, and internal hospital personnel regarding insurance benefits information.
- Estimated self-pay portions after calculation of deductibles, co-pays, and non-covered services.
- Obtained patient data information to facilitate verification.
- Maintained expert-level knowledge of available verification and eligibility tools.
- Maintained privacy and confidentiality of patients in compliance with policies and regulations.
- Scheduled x-rays and lab work for patients.
- Transmitted medical records and correspondence on behalf of patients and practitioners.
- Compiled medical reports covering specific patient or general office data.
- Updated patient medical records with direct intake information and transcribed practitioner messages.
- Interim Supervisor Assisted with new hire training.
Advance Medical Support Specialist
Department of Veteran affairs HCC
Charlotte, NC
- Perform customer service activities and process scheduling requests for veterans at the front desk as well as requests submitted by medical providers within the VA
- In this position, under direct supervision, my responsibilities include providing intake services, gathering information to complete veteran files as well as prepare needed documents for radiological procedures.
- Interacts with new and existing customers to provide and process information in response to inquiries, concerns, and requests.
Education
Master of Arts (M.A.) - Healthcare Administration
Pfeiffer University
Charlotte, NC12.2022
Bachelor of Arts (B.A.) - Healthcare Administration
Pfeiffer University
Charlotte, NC08.2017
Skills
- Statement drafting
- Benefits coverage assessment
- Eligibility assessment
- Data analysis
- Effective patient communication
Timeline
Insurance Verification Specialist
International Business Machines (IBM)
02.2023 - Current
Insurance Verification Specialist
Atrium Health
10.2021 - 02.2022
Medical Unit Clerk
Augusta University Medical Center
10.2019 - 10.2021
Insurance Verification Specialist
Novant Healthcare
01.2011 - 12.2016
Advance Medical Support Specialist
Department of Veteran affairs HCC
Master of Arts (M.A.) - Healthcare Administration
Pfeiffer University
Bachelor of Arts (B.A.) - Healthcare Administration
Pfeiffer University