Amber Moore
Philadelphia,PA
Summary
Dedicated administrative professional with strong communication and team-building skills. Proficient in medical terminology and scheduling, with several years of relevant work experience. Seeking a role that offers professional challenges and utilizes interpersonal skills, excellent time management, and problem-solving abilities. Known for dependability and success in managing multiple priorities with a positive attitude. Willing to take on additional responsibilities to help the team achieve its goals.
Overview
17
17
years of professional experience
Work History
Pre-Encounter Representative
Mainline Health
01.2021 - Current
- Provides and promotes professional, efficient and companionable customer service through all communication with patients, physicians, non-Mainline Health colleges, and co-workers.
- Initiating precertification manually and through software Waystar and Rhyme for outpatient advance imaging for Mainline Health Primary Care and Specialty patients.
- Leveraged skills in precertification to lead the team, cutting lost revenue by 20% in 2023 through better processes and customer engagement.
- Explaining processes, forms, and procedures to patients, ensuring that they understand required documentation requirements and subsequent measures.
- Work closely with radiology departments and medical staff to coordinate scheduling and ensure all necessary authorizations are obtained before procedures.
- Provides multiplied lines of communications and contacts other resources when necessary, such as physician’s office, insurance vendors and medical facilities to obtain the required insurance registration information.
- Handle and resolve denials by preparing and submitting appeal letters, providing additional documentation, and addressing any issues raised by insurers.
- Maintain accurate and organized records of authorization requests, approvals, and denials for compliance and audit purposes.
- Respond rapidly to changing circumstance and adapt to make changes work includes Mainline Health policy, guidelines and regulations.
- Attends weekly meetings to ensure all projects remain on track. This includes reviewing current progress, addressing any concerns, and discussing potential improvements.
- Pitches new ideas to enhance project outcomes and streamline departmental processes.
Central Scheduling Preprocessing Specialist
Mainline Health
01.2019 - 01.2021
- Serves as the first point of contact for patients and physicians scheduling outpatient diagnostic procedures at Main Line Health Hospitals and diagnostic centers.
- Collecting all required patient information, including scheduling, preregistration, and insurance verification.
- Obtaining and accurately entering necessary demographic, clinical, and billing information.
- Answering, screening, and processing requests and telephone inquiries with adherence to HIPAA and HITECH confidentiality policies and procedures.
- Explaining processes, forms and procedures to callers, ensuring that patients understand required documentation requirements and subsequent measures.
- Providing professional, compassionate, and concierge-like service to patients.
- Educate employees on precertification WayStar system
- Experienced in software Epic, Evicore, Navinet, United Healthcare, Pear, Availity, UPMC, RadMD, HealthHelp and other insurance vendors.
Senior Bank Specialist/Procurement Officer Assistant
Police & Fire Credit Union
01.2009 - 01.2019
- Maintain effective customer relationships and manage all management services and loans
- Monitor all referrals and walk-in customers and acquire new customers for branch and develop cross-sell opportunity
- Coordinate with staff to resolve all issues for banking transactions and products/services for the branch
- Record loans and prepare necessary documentations, track and trace all other investment activities
- Monitor all customer inquiries; resolve all problems efficiently within timeframe
- Establish appropriate operational support in call center to assist various customer services issues
- Service all accounts including but not limited to new accounts, loans and business accounts from start to finish
- Aids procurement officer in all aspects
- Gathered information and created reports from all departments
- Presented reports to the procurement officer, relaying information from department heads accurately
- Communicated information from the procurement officer to the rest of the management team
- Strong knowledge of all PFFCU products and services
- Complete training and consistently practice the 5 Step TME process on both sides of the office when needed.
Operations Sales Manager
TJ Maxx
11.2007 - 06.2009
- Performance Management: Developed personnel by assessing performance, counseling and training to support continuous improvement within TJ MAXX customer-driven environment
- Worked with Sales team to create and maintain a culture focused on delivering results by providing ongoing coaching and development of the team
- Developed the management and stock room personnel by assessing performance, counseling, and training to support continuous improvement
- Developed action plans to improve sales effectiveness of TJ MAXX team insuring performance levels never to drop below expected market levels
- Assisted executive management in developing and maintaining sales reporting and analytics requests
- Worked directly with other Sales Management to provide timely sales analytics including weekly pipeline analysis, forecasting, and sales results.
Education
High School Diploma -
Freire Charter School
Philadelphia, PA06.2007
Skills
- Patient Care
- Customer Service
- Revenue Generation
- Multitasking Abilities
- Excellent Communication
- Teamwork and Collaboration
- Attention to Detail
- Organizational Skills
- Problem-Solving
- Phone Etiquette
- Microsoft Excel
- HIPPA Compliance
- Extensive ability with reporting and analytics, as well as an ability to interpret data and identify trends/make suggestions
- Medical Scheduling
- Insurance Verification
- Epic
- Medical Records and Terminology
- Administrative Experience
- Medical Transcription
Timeline
Pre-Encounter Representative
Mainline Health
01.2021 - Current
Central Scheduling Preprocessing Specialist
Mainline Health
01.2019 - 01.2021
Senior Bank Specialist/Procurement Officer Assistant
Police & Fire Credit Union
01.2009 - 01.2019
Operations Sales Manager
TJ Maxx
11.2007 - 06.2009
High School Diploma -
Freire Charter School
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