April Cooper

• Verifying insurance/compliance is met in order for the facility to meet revenue goals (Educate the patients in detail of the process).
• Processed prior authorization requests in accordance with departmental guidelines.
• Researched patient eligibility, coverage information, and benefit levels.
• Analyzed denials received from third party payers to identify trends in denials and develop proactive measures for resolution.
• Verifying of insurance/3rd party payor sites, provides estimates for patients prior to services. Answer incoming calls/questions concerning insurance or estimates, verify status of authorizations. Educate patients on their financial responsibility and insurance benefits. Process/Post payments, verify authorizations, RTE (Run benefit checks prior to creating estimates).

• Led and motivated employees through supervision, training and coaching on duties and daily operational activities.
• Resolved conflicts between physicians, nurses and administrative staff to maintain optimal workflows.
• Managed operations in accordance with budget requirements.
• Implemented new hire training to further develop skills and initiate discussions on task prioritization.
• Initiated training and education programs for supporting healthcare staff.
• Participated in meetings with department heads to discuss census information, admissions and discharges for residents.
• Opened a new clinic in Cary, NC (Assisted in the paperwork preparation).
• Created copay and other Manager reports to ensure Joint Commission standards are met.
• Led meetings among my employees in order to update them of any new information.
• Completed 30, 60, 90 days evaluations and mid/end of the year evaluations.
• Ordered clinic supplies and managed the PRMO budget.
• Manages 2 Women Health (OB/GYN) clinics.

-Served as team lead with the absence of Supervisor.

-Verified documentation, and maintained compliance with relevant regulations to facilitate patient access to care and ensure facility and providers are eligible for payment.

-Conducted training of team members to maximize their potential.

-Verifying of insurance/3rd party payor sites, provides estimates for patients prior to services. Answer incoming calls/questions concerning insurance or estimates, verify status of authorizations. Educate patients on their financial responsibility and insurance benefits. Process/Post payments, verify authorizations, RTE (Run benefit checks prior to creating estimates). Serviced as main trainer to educate new employees based on the departmental needs.
In addition:
-Determine if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
-Admit, register and pre-register patients with accurate patient demographic and financial data.
-Resolve insurance claim rejections/denials and remedy expediently.
-Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.

Monitors financial outcomes Applies appropriate adjustments/Take electronic payments Assures payments are posted appropriately Set up payment plans based off of the affordability of the patient Answered inbound calls per day and directed to designated individuals or departments. Accessed "Hyland" to evaluate insurance claims. Educated the patient with the EOB.

Analyze insurance coverage and benefits for service to ensure timely.
Obtain authorizations based payment on insurance plan contracts and guidelines.
Document billing system.
Explain bills provides assistance to visitors and patients.
Explain policies and departmental coverage as requested.
Calculate and according to PRMO credit and collection policies.
Implement appropriate collect cash payments appropriately for all patients.
Reconcile daily necessity of third party sponsorship and process patients in accordance reimbursement.

Produced professional and error-free letters, presentations and spreadsheets Scheduled Operational surgeries Re-organized the doctor's calendar Scanned documents, filed, faxed Requested Medical Records from outside facilities Coordinated travel arrangements, including booking hotel rooms, car rentals and airfare for staff traveling to domestic and international locations Ordered office supplies (Staples)

• Offered patients information and assistance navigating insurance coverage.
• Received underwriting approvals after accurately completing applications for insurance coverage.
• Developed coordinated protection plan by calculating and quoting rates for immediate coverage action for uninsured clients.
• Participated in weekly training sessions to improve product knowledge and enhance company growth.

Developed exceptional attendance record with special attention to punctuality and preparation to work upon arrival Received and posted payments to patient accounts Scheduled patients for future/return appointments Checked patients in/out of clinic Verified insurance Part of a team used to transfer IDX over to Epic

Devised public relations strategies to engage with and influence general public in support of accomplishing business objectives and boosting revenues Provided exceptional support concerning directory assistance Assisted providers with paging concerns or issues Sent out Emergency and Weather Alerts Served as Emergency Operator while dispatching the appropriate team Assisted with paging the provider on call for DAN-Divers Network.

• Built trust and rapport with patients by showing compassion and empathy in variety of situations.
• Scheduled appointments for patients to be seen by health providers.
• Verified health insurance prior to new appointments.
• Faxed/emailed clinical notes to external health facilities when needed.
• Requested for medical records from external health facilities.
• Filed documents after scanning to medical records.
• Extensively educated patients on their health benefits and coverage.

Screened housing applications for prospective residents, prepared move in packets once new residents. Filed, copied, and scanned documents into the system.