Anika S. Cook
Princeton,TX
Summary
Dependable Coordinator provides excellent office management and administrative support. Possesses strong communication and interpersonal skills with demonstrated ability to manage competing priorities and meet deadlines. Creative problem solver with strong analytical and critical thinking skills.
Overview
11
11
years of professional experience
Work History
Reimbursement Case Manager
CareMetx
09.2023 - Current
- Acts as single point of contact and voice for all providers and patients. Works as a patient advocate and always demonstrates compassion.
- Coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support services.
- Determines patient's eligibility and conducts patient enrollment activities (copay assistance).
- Performs reimbursement related activities such as benefit investigation, prior authorizations, appeals, etc.
- Maintain frequent phone contact with patients, healthcare providers, and pharmacy staff.
- Extensive knowledge of HIPAA regulations and follows all company policies.
- Manages case load depending on the parameters of the program.
Inpatient Care Coordinator
United Healthcare/Optum
02.2018 - 03.2024
- Receiving and reviewing new inpatient and skilled nursing admission notifications (up to 150 cases per day).
- Confirming member eligibility to determine if coverage is still in place.
- Collecting admission/discharge status and entering into case.
- Maintaining a high level of data integrity in all case to ensure the most accurate daily blended census report and associated bed day reporting.
- Based on diagnosis and procedure codes, assigning a case to the appropriate Inpatient Care Manager for priority review, calling out to confirm codes if necessary.
- Entered data, generated reports, and produced tracking documents.
Patient Scheduler/ Medical Billing
Warthan Dermatology Center
06.2015 - 08.2016
- Aligned appointments with clinical protocols of different departments and clinical professionals.
- Prepared patients for scheduled procedures, educating on protocols and completing required documentation.
- Completed accurate scheduling work by multitasking between multiple systems.
- Researched and replied to insurance, patient and internal customer inquiries.
- Reviewed claim denials and payer requirements for corrective action.
- Followed up and collected on outstanding balances and receivables.
- Identified account discrepancies and issues inhibiting claim payments.
- Oversaw and ran necessary reports for monthly and quarterly reporting.
- Provided compassionate support to patients during their healthcare journey, addressing concerns and answering questions about appointments promptly.
- Maintained confidentiality and adhered to HIPAA regulations when handling sensitive patient information during the scheduling process.
Scheduling Manager
Texas Institute for Neurological Disorders
12.2014 - 06.2015
- Oversaw schedules by engaging individuals through text, call and email.
- Avoided overbooking and errors through proactive communication about new appointments and schedule changes.
- Identified and addressed call-offs, no-shows and other issues impacting scheduling.
- Monitored staffing requirements and maintained compliance with accreditation body.
- Managed schedules with daily bookings, availability determinations, and rescheduling.
- Boosted efficiency and team performance by setting goals and plans to achieve each target.
- Managed more than 10 clerical and administrative personnel.
Charge Entry Specialist/ Patient Access Representative
Victory Medical Center
08.2013 - 12.2014
- Communicated with physicians and medical providers to clarify and facilitate clinical requests.
- Obtained and updated patient personal and financial information.
- Verified insurance eligibility, referral authorization, and financial education.
- Entered all hospital surgical charges into the system without error.
- Worked closely with materials management regarding purchase orders for supplies and implants for surgeries.
- Worked closely with the corporate billing department regarding charges and billing issues.
- Trained new employees.
Education
Bachelor of Science - Healthcare Management
Capella University
Minneapolis, MN12.2014
Skills
- Escalation problem-solving
- Issue research
- Account updates
- Problem solving
- Self-starter
- Good communication
- Critical thinking
- Ability to multitask
- Time management
- Critical Thinking Skills
- Effective Listening
- Data Entry
- Work Planning and Prioritization
- Relationship Building
Timeline
Reimbursement Case Manager
CareMetx
09.2023 - Current
Inpatient Care Coordinator
United Healthcare/Optum
02.2018 - 03.2024
Patient Scheduler/ Medical Billing
Warthan Dermatology Center
06.2015 - 08.2016
Scheduling Manager
Texas Institute for Neurological Disorders
12.2014 - 06.2015
Charge Entry Specialist/ Patient Access Representative
Victory Medical Center
08.2013 - 12.2014
Bachelor of Science - Healthcare Management
Capella University