Angela D Powell
Medical Office Manager
Philadelphia,PA
Summary
Dedicated Healthcare Professional & MS in Health Administration.
- Dedicated professional with 15+ years of experience in patient access, scheduling, medical records, and billing, driving efficiency and customer satisfaction in fast-paced healthcare environments.
- Robust knowledge of medical terminology, insurance verification, billing/coding, and HIPAA regulations, with proficiency in Epic, IDX, HCHB Home Care Software, and Microsoft Office Suite.
- In-depth expertise in inpatient and outpatient services, medical records management, and administrative support, with a passion for patient education on hygiene, nutrition, and wellness.
- Technical skills in inpatient/outpatient billing, claim management, scheduling, rescheduling, insurance verification, pre-authorization, and referrals, with strong understanding of ICD-9/10, CPT, HCPCS, OSHA, HIPAA, patient admission/discharge, and medical terminology.
- Proficient in Epic, IDX, HCHB Software, Microsoft Word, PowerPoint, Excel, and Cisco phone systems, streamlining operations and improving patient outcomes.
- Currently pursuing a Master of Science in Health Administration, committed to staying current with industry trends and best practices.
- Dedicated to delivering exceptional patient care and support by leveraging technical skills to optimize healthcare operations.
Confident in ability to positively impact healthcare delivery and patient satisfaction in a challenging role.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Homecare Scheduler
Holy Redeemer Home Care
12.2022 - Current
- Supervised a team of four schedulers, providing guidance and oversight to ensure efficient scheduling operations.
- Coordinated schedules for a team of ten home care nurses and ten physical therapists, prioritizing timely and continuous patient care.
- Scheduled initial assessments, ongoing visits, and emergency interventions based on patient acuity and needs.
- Managed scheduling conflicts and last-minute changes, rearranging assignments to maintain seamless care delivery.
- Collaborated with intake staff to gather patient information and determine appropriate staffing and disciplines required.
- Worked closely with clinical managers to ensure adequate staffing ratios, compliance with regulations, and high-quality patient care.
- Implemented process improvements, reducing scheduling errors by 12% and increasing staff satisfaction scores by 9%.
- Provided exceptional leadership and mentoring schedulers to enhance their skills and promote a positive team environment.
Utilization Review Coordinator
Molina Healthcare
03.2022 - 07.2022
- Reviewed the theoretical necessity for 500+ patient cases monthly, ensuring compliance with evidence-based guidelines and insurance criteria.
- Analyzed data to identify trends and opportunities for cost reduction while maintaining quality of care.
- Collaborated with physicians and care teams to develop and implement optimal treatment plans, resulting in an average hospital stay reduction of 1.2 days ($200,000 annual savings).
- Communicated with patients, families, and insurance companies to address questions and resolve issues in a customer-focused manner.
- Managed complex cases involving multiple medical conditions, coordinating care among various specialists while adhering to strict timelines for decision-making.
- Participated in external audits and surveys, providing documentation and insight to demonstrate the effectiveness of the utilization review program.
Utilization Review Coordinator
AmeriHealth Caritas/Keystone First
09.2020 - 03.2021
- Supervised a team of 10 clinical care reviewers, providing guidance on complex medical necessity determinations and mentoring for professional development.
- Conducted in-depth inpatient and outpatient records reviews to determine medical necessity, applying InterQual criteria, and collaborating with physicians as needed.
- Led interdisciplinary team meetings, facilitating discussion on patient progress, treatment plans, and care coordination strategies to achieve optimal outcomes.
- Ensured 100% compliance with NCQA and URAC regulations through rigorous auditing, accurate documentation, and corrective action implementation.
- Developed and delivered educational programs for clinical staff on documentation best practices, resulting in a 25% reduction in downloading and denials.
- Increased efficiency of the utilization review process through regular communication with insurance companies for timely authorizations.
Patient Access Specialist
Thomas Jefferson Hospital
10.2019 - 09.2020
- Leveraged 10+ years of customer service experience to excel as a patient representative, ensuring smooth access to care.
- Proficient in obtaining prior authorizations from diverse insurers, including Health Partners, Horizon BCBS, AETNA, Medicare, Keystone First, and Ameri Health.
- Verified insurance benefits and eligibility, providing accurate procedure and diagnosis codes to facilitate necessary tests and procedures.
- Maintained unwavering commitment to patient confidentiality, strictly adhering to HIPAA guidelines and hospital policies.
- Managed approximately 30 inbound calls per day from patients regarding insurance, delivering exceptional customer service and prompt issue resolution.
- Collaborated seamlessly with clinical staff to coordinate patient care, ensuring efficient service delivery.
- Collected and accurately entered patient demographic and insurance data into an electronic database.
- Demonstrated empathy and professionalism when handling sensitive situations involving distressed patients.
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
Patient Access Navigator 2
Cooper University Hospital
06.2015 - 10.2019
- Scheduled appointments and facilitated timely access for patients to multiple specialties across Cooper Hospital, including Gastroenterology, Cardiology, Endocrinology, Neurology, Neurosurgery, Orthopedics, Podiatry, Physical Medicine & Rehabilitation, Pulmonology, and OB/GYN.
- Enhanced navigational accuracy by 25% through consistent updates and maintenance of electronic charts and navigation tools.
- Streamlined communication between departments, proactively problem-solving to ensure seamless patient flow.
- Collaborated with clinical teams to promote efficient access to care, supporting positive patient experiences.
- Managed high-volume scheduling for a large patient population, prioritizing effectively to minimize delays.
- Adhered strictly to HIPAA guidelines, ensuring confidentiality and security of patient information.
- Provided exceptional customer service, addressing patient inquiries and concerns professionally and compassionately.
- Increased navigational accuracy by consistently updating and maintaining electronic charts and navigation tools.
Assistant Coordinator
ADL Services
07.2013 - 04.2014
- Coordinated essential resources for elderly and disabled clients to support safe and independent living at home.
- Arranged transportation, medical services, meal delivery, and wellness programs tailored to individual client needs.
- Taught clients and caregivers about proper hygiene practices and assisted with daily living activities as needed.
- Managed comprehensive personal files, budgets, and annual evaluations for a caseload of 25 clients.
- Tracked budgets and expenses meticulously, ensuring fiscal responsibility and accountability.
- Identified process inefficiencies and proposed solutions, contributing to a 15% increase in department productivity.
- Collaborated with supervisor to assess client needs, develop care plans, and implement effective interventions.
- Provided administrative support, including scheduling, record-keeping, and communication with families and staff.
- Attended staff meetings, notified parents regarding special events, and interacted with families on a routine basis.
The Patient Account Technician
New Hanover Regional Medical Center
11.2012 - 06.2013
- Managed inpatient and outpatient claims billing, ensuring accurate submission to Medicare, Medicaid, and commercial insurers.
- Resolved 1500 claim edits and adjustments daily, rectifying errors and discrepancies to facilitate timely reimbursement.
- Handled over 100 inbound calls daily from patients and insurers, addressing inquiries and resolving issues promptly and professionally.
- Received, researched, and resolved member grievances, collaborating with internal teams to find satisfactory solutions.
- Posted payments and adjustments, maintaining accurate and up-to-date patient account records.
- Identified and implemented process improvements, streamlining claim submission and reducing denial rates by 12%.
- Collaborated with patient access and clinical departments to ensure complete and accurate information for billing purposes.
- Adhered to HIPAA regulations, maintaining confidentiality and security of patient financial information.
Clerk Five /Orthopedic And Physical Therapy
Temple University Hospital
06.2004 - 11.2012
- Coordinated access to care for orthopedic and physical therapy patients, scheduling appointments and procedures.
- Verified insurance benefits and obtained necessary authorizations, ensuring smooth billing and reimbursement.
- Managed medical records, triaging phone messages and inquiries from patients and providers.
- Provided exceptional customer service, addressing patient concerns and facilitating timely resolution of issues.
- Collaborated with clinical staff to ensure seamless care coordination for orthopedic and physical therapy patients
- Implemented process improvements, streamlining patient intake and reducing wait times by 20%.
- Maintained strict adherence to HIPAA guidelines, ensuring confidentiality and security of patient information.
- Prepared and submitted accurate claims for orthopedic and physical therapy services to Medicare, Medicaid, and commercial insurers.
- Researched and resolved billing discrepancies and rejections, reducing days in A/R by 12%.
- Conducted regular audits to ensure compliance with coding and billing regulations.
- Collaborated with patient access staff to obtain complete and accurate information for billing purposes
- Provided exceptional customer service, addressing patient billing inquiries and resolving issues promptly and professionally.
Education
Master of Science - Health Administration
University of Phoenix
Phoenix, AZ01.2025
Bachelor of Science - Health Management
University of Phoenix
Phoenix, AZ01.2024
GED -
Connelly Skill Learning Center
Pittsburgh, PA06.1985
Skills
- Critical Thinking
- Teamwork and Collaboration
- Problem-Solving
- Medical Terminology
- HCHB Home Care Software
- Computer Skills
- Microsoft Office Suite
- Calendar Management
- Insurance Verification
- Medical Billing
- Patient Registration
- Multitasking Abilities
- Decision-Making
- Team building
Certification
- Medical Assistance, Bradford Business School, 09/1993
- Health Life Insurance Agent License 2018
Accomplishments
- I used Microsoft Excel to develop inventory tracking spreadsheets.
- Supervised a team of 20 staff members.
Certifications:Medical Assistance, Bradford Business School, 09/1993Health and Life Insurance Agent
I'm excited to share my background and qualifications with you. I hold certifications as a Medical Assistant and License Life & Health Insurance Agent,
My Medical Assistant certification has equipped me with a strong foundation in healthcare's clinical and administrative aspects. I'm well-versed in patient assessment, medical procedures, and maintaining accurate records. I thrive in fast-paced environments and am deeply committed to providing compassionate care, ensuring that every patient feels understood and cared for.
In addition to my healthcare background, I've also pursued a career as a Life & Health Insurance Agent. I understand the importance of having the right coverage to protect individuals and families. My knowledge spans various types of insurance, including term life, whole life, disability, and long-term care. I'm dedicated to helping clients make informed decisions about their insurance needs.
To enhance my business acumen, I attended Bradford Business School. This program refined my skills in marketing, finance, and management. I learned how to run a practice effectively, manage staff, and streamline operations.
I'm passionate about merging my medical and business backgrounds to deliver exceptional patient care. I'm excited to bring my unique skills and experience to a new challenge.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimePart TimeContract WorkWork Location
RemoteOn-SiteImportant To Me
Career advancementWork-life balancePersonal development programsHealthcare benefitsWork from home optionPaid time offPaid sick leave401k matchTimeline
Homecare Scheduler
Holy Redeemer Home Care
12.2022 - Current
Utilization Review Coordinator
Molina Healthcare
03.2022 - 07.2022
Utilization Review Coordinator
AmeriHealth Caritas/Keystone First
09.2020 - 03.2021
Patient Access Specialist
Thomas Jefferson Hospital
10.2019 - 09.2020
Patient Access Navigator 2
Cooper University Hospital
06.2015 - 10.2019
Assistant Coordinator
ADL Services
07.2013 - 04.2014
The Patient Account Technician
New Hanover Regional Medical Center
11.2012 - 06.2013
Clerk Five /Orthopedic And Physical Therapy
Temple University Hospital
06.2004 - 11.2012
Master of Science - Health Administration
University of Phoenix
Bachelor of Science - Health Management
University of Phoenix
GED -
Connelly Skill Learning Center
- Medical Assistance, Bradford Business School, 09/1993
- Health Life Insurance Agent License 2018
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