AMBER TURNER

Responsible for Medi-cal inpatient services. Received faxed face sheets and verified member eligibility. Entered appropriate information to be processed in a timely manner. Corresponding and assisted medical staff with urgent matters regarding member eligibility and turnaround time procedures. Generated provider and member letters for denial of healthcare services. Generated member language letters as needed.

• Responsibilities include. Processed incoming authorization requests and updated patients charts accordingly.
• Reviewed demographic, clinical and insurance information before sending to referred specialists.
• Adhered to HIPAA regulations when handling confidential patient information.
• Reviewed and approved authorization requests according to insurance and diagnosis
• Verified and updated requested documents to complete the 360 referral process

• Monitor and process pre-authorization via Filenet, completed authorization task, verify members eligibility, initiate LTC authorization process for Health Net patients residing in long term care facilities
• Reported accurately all specialist referrals to administration as directed.

• Communicated effectively via email, phone, or chat with plan participants to resolve issues pertaining to health insurance benefits.
• Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
• Provided assistance to plan participants by explaining benefits information to ensure educated selections.
• Assisted clients in understanding their rights under COBRA and other state mandated programs.
• Maintained records of employee benefit data such as enrollments, changes, terminations and plan costs.

• Responsibilities included responding to a high volume of incoming calls and inquiries inquiring postal deliveries via Fed Ex US Postal etc.
• Responding to customer emails and chats to reactivate access code for secured lockers and troubleshooting hardware and software issues.
• Solving resident issues using critical thinking
• Used proactive monitoring procedures and tools to identify problem prevention opportunities.

• Responsibilities included enrolled consumers into subsidized healthcare plans
• Assisted consumers with completed online application
• Verified and confirmed applicants' citizenship and identity using federal data hub
• Assisted consumers in completing Medi-cal application and referred to local county
• Consulted with Medi-cal worker regarding consumers application status and process.

• Responsibility included consulting customers via online or email, enrolled clients into medical and dental savings plans, trained and created a marketing strategy for each new employee designed to fit their own personality, prepared employee hiring records explained human resources policies, procedures, and standards to new employees
• Followed up on delinquent account discussed and implemented payment plans with clients.

• Responsibility included the workflow of patient registration for outpatient services and emergency visits, prepared, cleaned, and sanitized patient waiting rooms and bathrooms
• Assumed the duties of patient intake that included: insurance verifications, scheduling appointments, pre-authorizations, updating of referrals, patient registration, as well as applying the patients for temporary Med-Cal benefits in addition to collecting delinquent copays
• Implemented a training manual and the training of new employees on office procedures.

• Assisted patients in determining their needs of scheduling or canceling appointments, and/or referring them to the correct staff member
• Trained employees on (EPIC) scanning software to include scanning all patient records into EPIC media reported to HIM, abstracting patients charts before their appointments or services rendered
• Managed patient information and abstracted each diagnosis and patient demographics into electronic medical records
• Called patients and collected on aged accounts
• Verified insurance and coverage before services are rendered.

• Organized information for past-due accounts and transferred to collection agency.
• Created monthly aging reports to identify delinquent accounts for review by management team.
• Provided administrative support to staff members, included copied and scanned documents, filed paperwork, and ordered supplies.
• Maintained records and updated patient information.
• Organized office operations and procedures, prepared monthly reports.