April Young
Missoula, MT,MT
Summary
Analytical, detail-oriented and dependable Medical Insurance Coordinator offering 26 years of experience within a fast-paced, high volume revenue cycle management office at a multi-specialty clinic. Highly organized in multitasking and managing large volumes of workloads while also training staff and keeping a positive attitude. Willing to take on added responsibilities to meet department goals. Skilled in quickly resolving issues and liaising between insurance providers, companies and policyholders. Well-versed in Medicare, Medicaid, HMO and PPO, worker's compensation, and commerical insurance. Skilled in mentoring team members to deliver exceptional service and building team morale through effective communication and positive performance. Hardworking professional committed to providing outstanding leadership and customer service to both colleagues and patients. Strongly believe in team decision-making, respect for one another and being willing to seek improvement.
Overview
28
28
years of professional experience
Work History
Insurance Coordinator
Tamarack Management Inc.
10.2015 - Current
- Worked directly with the Revenue Cycle Director and Supervisor to ensure all aspects of the business office ran efficiently.
- Participated in interviews and the hiring process.
- Mentored and trained new hires within the department.
- Streamlined office workflows for increased productivity, organizing and maintaining office procedures.
- Contributed positively to team morale by consistently demonstrating a collaborative attitude and willingness to support colleagues.
- Maintained confidentiality of patient finances, records, and health statuses.
- Posted charges, patient payments and insurance payments/denials.
- Monitored claim allowances and adjustments, ensuring claims processed at the correct contracted rates. Worked with the insurance and/or network representatives to have incorrectly priced claims reprocessed.
- Prepared insurance claim forms or related documents and reviewed for completeness. Filed both paper and electronic claims.
- Reviewed denied claims and did appropriate follow up. Contacted the insurance company via phone or provider portal. Referred claims to the coding specialist to be audited. Obtained retro authorization for outpatient procedures when denied. Rebilled and submitted corrected claims.
- Verified insurance coverage and patient registration and updated as needed.
- Provided back up coverage for Financial Counselors. Received incoming calls, promptly resolving questions or concerns while providing accurate information, collecting payments and/or set up payment plans.
- Maintained compliance with local, state and federal regulations governing insurance, Medicare and Medicaid requirements.
- Carried out administrative tasks when needed such as sorting and distributing mail and scanning documents.
- Requested insurance and patient refunds. Approved all insurance refunds requested by staff prior to being issued. Posted refunds to the account once checks were received from accounting.
- Communicated effectively with staff in the business office, as well as finance and clinical departments.
- Prioritized workload based on department needs to complete projects on time.
- Provided assistance in testing upgrades related to the Practice Management system (EPIC), as well as training staff.
Medical Office Receptionist
Montana Valley Eye Clinic
08.2013 - 10.2015
- Improved patient satisfaction by efficiently managing front desk operations and addressing inquiries professionally.
- Increased office productivity by multitasking efficiently during peak hours, handling multiple responsibilities simultaneously.
- Collaborated with medical staff to ensure seamless communication and coordination of patient care.
- Answered phones, scheduled appointments, greeted patients checking them in and out, collected payments.
- Pulled charts and prepared for nurse and doctor assessment.
- Provided exceptional customer service, promptly addressing concerns and resolving issues to maintain a positive environment.
- Reviewed and sent medical records to other physicians upon request.
- Assisted in billing processes, ensuring accurate records and timely payments from insurance companies and patients.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and protecting privacy rights.
- Participated in team meetings for continuous improvement of policies, procedures, and overall office operations efficiency.
- Maintained clean reception area, creating a comfortable environment for patients and visitors alike.
- Filed and retrieved patient records for provider.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Transcribed phone messages and relayed to appropriate personnel.
- Performed various administrative tasks by filing, copying and faxing documents.
Life Coach
Express Employment
02.2013 - 08.2013
- Established strong rapport with clients, fostering trusting and supportive coaching relationships.
- Encouraged clients to set and achieve reasonable goals on weekly basis.
- Utilized active listening skills to identify underlying client needs and develop targeted strategies accordingly.
- Helped clients build life management and coping skills to handle daily needs and specific stressors.
- Connected clients with available resources to improve plan success.
- Maintained detailed records of client interactions and progress towards goals, enabling accurate assessment of coaching effectiveness.
- Supported individuals dealing with mental health and emotional issues.
- Listened to clients' concerns and provided encouragement and support.
- Determined clients' risk of self-harm or other dangerous behaviors.
- Accompanied clients to doctor appointments.
- Assisted clients in meal planning and shopping.
Insurance Coordinator
Tamarack Management Inc.
06.1996 - 12.2012
- Worked in Medical Records and was then promoted to Front Office Receptionist. After a year and half I transferred to the Data Entry Department. Worked my way up from Data Entry to Insurance Coordinator.
- Worked directly with the Revenue Cycle Director and Supervisor to ensure all aspects of the business office ran efficiently.
- Participated in interviews and the hiring process.
- Mentored and trained new hires within the department.
- Streamlined office workflows for increased productivity, organizing and maintaining office procedures.
- Contributed positively to team morale by consistently demonstrating a collaborative attitude and willingness to support colleagues.
- Maintained confidentiality of patient finances, records, and health statuses.
- Posted charges, patient payments and insurance payments/denials.
- Monitored claim allowances and adjustments, ensuring claims processed at the correct contracted rates. Worked with the insurance and/or network representatives to have incorrectly priced claims reprocessed.
- Prepared insurance claim forms or related documents and reviewed for completeness. Filed both paper and electronic claims.
- Reviewed denied claims and did appropriate follow up. Contacted the insurance company via phone or provider portal. Referred claims to the coding specialist to be audited. Obtained retro authorization for outpatient procedures when denied. Rebilled and submitted corrected claims.
- Verified insurance coverage and patient registration and updated as needed.
- Provided back up coverage for Financial Counselors. Received incoming calls, promptly resolving questions or concerns while providing accurate information, collecting payments and/or set up payment plans.
- Maintained compliance with local, state and federal regulations governing insurance, Medicare and Medicaid requirements.
- Carried out administrative tasks when needed such as sorting and distributing mail and scanning documents.
- Requested insurance and patient refunds. Approved all insurance refunds requested by staff prior to being issued. Posted refunds to the account once checks were received from accounting.
- Communicated effectively with staff in the business office, as well as finance and clinical departments.
- Prioritized workload based on department needs to complete projects on time.
- Provided assistance in testing upgrades related to the Practice Management system (EPIC), as well as training staff.
Education
Medical Reception Certificate - Medical Reception
University of Montana
Missoula, MT05.1996
High School Diploma -
Frenchtwon High School
Frenchtown, MT05.1995
Skills
- Typing and 10 Key
- Attention to Detail
- Analytical
- Insurance processes
- Medicare and Medicaid knowledge
- Insurance claims processing
- Organizing and Prioritizing Work
- Data Entry
- Records Management
- Teamwork and Collaboration
- Appointment Scheduling
- Billing Software
- Prior authorization processing
- Decision-Making
- Documentation skills
- Eligibility Determination
- Critical Thinking
- Denied claims identification
- Customer service and assistance
- Knowledge of ICD-10 and CPT coding
- Strategic thinking skills
- Medical billing and coding
- Microsoft Office
- Payment planning
- Revenue Cycle Management
- Insurance Coverage Verification
- Understanding of medical terms
- Excellent administrative abilities
- Active Listening
- Medical Terminology
- Employee Interviews
- Proficient in writing appeal letters
Timeline
Insurance Coordinator
Tamarack Management Inc.
10.2015 - Current
Medical Office Receptionist
Montana Valley Eye Clinic
08.2013 - 10.2015
Life Coach
Express Employment
02.2013 - 08.2013
Insurance Coordinator
Tamarack Management Inc.
06.1996 - 12.2012
Medical Reception Certificate - Medical Reception
University of Montana
High School Diploma -
Frenchtwon High School
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