AMBER Kelley
Jonesboro,GA
Summary
Experienced Medical & Office Administrative professional with 10+ years of experience spanning healthcare administration, business operations, and patient/customer service with an educational background in Medical Reimbursement and Coding. Proven ability to operate in various levels of healthcare administration, operational planning, program management, and process improvement initiatives. Skilled in medical software systems (ADP - Pay Expert, EZ Labor Manager, HR Expert), Cerner, Futura, OPS, Athena, Windows Suite, QuickBooks Accounting, Epic, IDX, Cerner, Artiva.
Overview
16
16
years of professional experience
Work History
Medical Receptionist
Aylo Health
05.2024 - Current
A/R Follow-Up Collector
Parrallon Shared Services
01.2023 - 01.2024
- Work insurance pools and contact insurance companies to resolve claims that are not paid in a timely manner
- Follow up on Hospital/Facility accounts utilizing the UB-04 form
- Review EOB’s, remits, and payer correspondence in the course of performing account follow-up and escalate any identified issues to the appropriate area for review and response to expedite claim resolution
- Identify problem accounts and escalate as appropriate
- Maintain compliance with pool completion requirements
- Retain required productivity and QA standards
- Provide documentation and notations in the patient account record to identify actions taken on the account
- Work with patients and guarantors resolve payer requests and discrepancies to promptly
- Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”, as well as all policies and procedures related to the Collections department.
Schegistrar
VCU Health Systems
01.2018 - 01.2023
- Responsible for verifying all patients’ insurances regarding upcoming appointments
- Conduct audits on accounts that have been denied by insurance companies, and to identify the root cause for resolution
- Schedule appointments for the Radiology and Oncology department, and the management of multiple personnel calendars
- Meet all customer call guidelines including service levels, handling time, and productivity
- Adhere to all confidentiality requirements at all times, to provide a confidential workplace for patient information
- Reviewed and resolved delinquent accounts on assigned A/R maintaining the minimum standard of collector productivity.
Medical Receptionist/Medical Records Clerk (Temp Assignment)
Family Healthcare
01.2016 - 01.2018
- Welcomed patients and visitors by greeting them in person or on the telephone to answer or refer inquiries
- Optimized patients' satisfaction, provider time, and treatment room utilization by scheduling appointments
- Kept patient appointments on schedule by notifying provider of patient's arrival, reviewing service delivery compared to schedule, and reminding provider of service delays
- Comforted patients by anticipating patients' anxieties, answering patients' questions, and maintaining the reception area
- Maintained business office inventory and equipment by checking stock to determine inventory level, anticipating needed supplies, placing and expediting orders for supplies, and scheduling equipment service and repairs
- Protected patients' rights by maintaining confidentiality of personal and financial information
- Retrieved all medical records from clinic nursing stations for filing and assembled medical charts
- Maintained confidentiality of all client information in accordance with HIPPA guidelines
- Appropriately filed medical, imaging, and lab sheets in medical records
- Facilitated copy of records for transfers in accordance with HIPAA guidelines.
Office Administrator / Reimbursement Specialist
Nascott Orthotics and Prosthetics/Hanger Clinic
01.2012 - 01.2016
- Reviewed and resolved delinquent accounts on assigned A/R maintaining the minimum standard of collector productivity
- Recorded accurate and detailed notes in accounts pertaining to payment status, denials, and action taken
- Compiled all necessary documentation to file claims and effective appeals to insurance companies
- Conducted outbound calls daily to insurance companies using adequate negotiation and analytical skills
- Kept up on current industry trends and compliance issues including the Fair Debt Collection Practices Act
- Reviewed and processes denials and correspondence within 72 hours of receipt
- Answered phone calls and directed calls to appropriate personnel, while maintaining professional communication skills
- Provided the highest level of customer service is provided to patients, fellow employees, and referral sources
- Obtained accurate insurance information, verification, and pre-authorization
- Processed all billing daily, ensuring that claims are accurate, timely, and fully documented
- Followed up on all open accounts, maintaining thorough chronological financial records on each patient account
- Provided counseling to patients advising them of their financial responsibility and obtained credit agreements for outstanding balances
- Applied payments and adjustments to patient accounts, processed deposits, and maintained accurate records of all cash received and in accordance with Company policy
- Maintained accurate and complete patient files, ensuring that they are following Hanger Compliance Policies
- Ensured the privacy and security of protected health information per HIPAA requirements
- Assisted with quality assurance to ensure patient satisfaction with PCC services as necessary
- Complied with the system of internal controls to ensure proper handling of cash receipts, including billing system data entry and bank deposits.
Medical Receptionist/Insurance Specialist
Infinite Technologies Orthotics and Prosthetics
01.2010 - 01.2012
- Responsible for receiving premium payments and preparing deposits
- Documented all communication with insurance carriers, as well as prospective and present customers
- Welcomed patients by greeting them in person or on the telephone to answer or refer inquiries
- Maintained security by following procedures and abiding by HIPAA laws
- Acted as liaison between practitioners and patients to provide a smooth and efficient patient experience
- Maintained safe and clean reception and exam rooms area by complying with procedures, rules, and regulations
- Ensured continuity among work teams by documenting and communicating actions, irregularities, and continuing needs
- Recorded demographic and insurance information into database
- Prepared and maintained all patient files including copying ID, scripts, referrals, and ensuring all forms are signed
- Coordinated the faxing of hospital orders and face sheets prior to sending required information to physicians
- Assisted with validating insurance coverage and followed up in regard to current and past due claims
- Maintained “stock and bill” billing for offsite facilities
- Scheduled and confirmed patient appointments
- In-depth knowledge of the insurance basic policies, procedures, strategies, and of federal, state, and local laws.
Education
Associates Degree in Medical Reimbursement & Coding -
Bryant & Stratton College
01.2024
Medical Billing & Coding Diploma -
Bryant & Stratton College
01.2023
CCA Certification -
AHIMA
01.2023
Skills
- Report Generation
- Customer Service
- General Accounting
- Policy & Procedures
- Payroll Processing
- General Operations
- QuickBooks Accounting
- Time Management
- General Administrative
Training
- Electronic Health Records
- ICD Procedural Coding
- ICD Diagnostic Coding
- CPT & HCPCS II Coding
- Evaluation & Management Services
- Clinical Documentation
- Advanced ICD Diagnostic Coding
- Advanced CPT & HCPS II Coding
Timeline
Medical Receptionist
Aylo Health
05.2024 - Current
A/R Follow-Up Collector
Parrallon Shared Services
01.2023 - 01.2024
Schegistrar
VCU Health Systems
01.2018 - 01.2023
Medical Receptionist/Medical Records Clerk (Temp Assignment)
Family Healthcare
01.2016 - 01.2018
Office Administrator / Reimbursement Specialist
Nascott Orthotics and Prosthetics/Hanger Clinic
01.2012 - 01.2016
Medical Receptionist/Insurance Specialist
Infinite Technologies Orthotics and Prosthetics
01.2010 - 01.2012
Associates Degree in Medical Reimbursement & Coding -
Bryant & Stratton College
Medical Billing & Coding Diploma -
Bryant & Stratton College
CCA Certification -
AHIMA
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