Amy Posada-Johnson
Oklahoma City,OK
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
17
17
years of professional experience
Work History
Financial Counselor
Oakwood Springs Hospital
Oklahoma City, Oklahoma
12.2020 - 07.2021
- Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
- Identified healthcare resources and programs for patients unable to meet financial obligations.
- Conducted interviews with patients and family members and answered questions regarding insurance benefits.
- Meticulously documented all details regarding contact with patients, providers and other individuals.
- Received and submitted customer payments to further reduce open account balances.
- Interviewed clients by telephone or in-person to gather financial information.
- Posted payments to accounts and maintained records.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Documented details regarding contact with patients, providers and other individuals in EPIC.
Admissions Clerk
Mercy Rehab Hospital
Oklahoma City, OK
08.2018 - 03.2020
- Communicate clearly and concisely within department and with other hospital departments
- Process patient’s hospital admission document, insurance information (including coverage verifications) and admission consents; provide information on admission policies/procedures to patients, family members and visitors
- Interact professionally with patient and family; provide explanations and reassurance when necessary
- Notify departments of procedures required during admission such as dialysis, PCA pump, surgery and ventilator
- Gather patient’s demographic and financial information; enter into hospital computer system
- Determines medical necessity, process referrals, insurance approvals and handle appeals
- Verified insurance information, collected payment or co-payment for services and created record of visit for future billing
- Accurately inputted patient and insurance information into company's computer system using EPIC
Worker’s Compensation & Claim Adjuster
Gallagher Bassett Services
Oklahoma City, OK
04.2012 - 09.2017
- Investigates losses to determine cause, scope and extent of damages and/or liability and possible subrogation
- Evaluates claims for purposes of setting reserves and providing appropriate payments
- Achieves fair and timely claim disposition consistent with internal and customer expectations
- Documented and communicates claim activity timely and effectively, and in manner which supports outcome of claim file
- Communicates effectively with claimants, and internal or external customer contacts.
- Identified issues, analyzed information and provided solutions to problems
- Offered friendly and efficient service to customers, handled challenging situations with ease
Claims Benefit Specialist
Aetna
Oklahoma City, OK
07.2001 - 03.2011
- Documents and tracks contacts with members, providers and plan sponsors
- Acts as mentor to new team members, assisting them with policy, process, procedure, system and documentation questions
- Maintains knowledge of benefit changes, policy updates and benefit revisions
- Process claim referrals, new claim handoffs, nurse reviews, complaints, grievance and appeals via target system
- Deftly handles extensive file review requests
- Assists in compiling claim data for customer audits
- Determines medical necessity, applicable coverage provisions and verifies member plan eligibility
- Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management
- Effective triage of phone calls to assist or re-direct as appropriate
- Communicates effectively with claimants, and internal or external customer contacts
- Ability to think critically, solve problems, plan and organize activities to serve clients effectively
- Act as client resource for administrative questions regarding enrollment, eligibility, and special contract provisions.
Education
Some College (No Degree) -
Rose State College
Midwest City, Ok Skills
- Proficient in Microsoft Office Suite; Word
- Excellent Verbal and Written Communications Skills
- Self Motivated, Team Player
- Responsibly and Respectfully Handles Confidential Information
- Meets Goals and Deadlines
- Provides Conflict Resolution for Internal and External Customers
- Punctual and Dependable
- Effectively Multi-Tasks in Organized Manner
- Maintains HIPAA Compliance (Health Information Portability and Accountability Act)
- Telephone etiquette
- Positive patient experiences
- Insurance Verification
- Patient counseling
- Cash Handling
Accomplishments
- Annual Training
- Health Insurance Portability and Accountability Act (HIPAA)
- California Title 10, 11 & 12
- Healthcare Reform Laws
- Business Integrity and Conduct
- Rose State College - August 2011 - 2013
- General Studies
Timeline
Financial Counselor
Oakwood Springs Hospital
12.2020 - 07.2021
Admissions Clerk
Mercy Rehab Hospital
08.2018 - 03.2020
Worker’s Compensation & Claim Adjuster
Gallagher Bassett Services
04.2012 - 09.2017
Claims Benefit Specialist
Aetna
07.2001 - 03.2011
Some College (No Degree) -
Rose State College