Arlene Holder
Hyattsville,MD
Summary
Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Dedicated [Industry] professional with a history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
19
19
years of professional experience
Work History
Confidentially manage patient accounts
Medstar Georgetown University Hospital – Department of Urology
2022.06 - Current
- Ensures the performance of daily scheduling edits as necessitated by provider schedule changes
- Ensure compliance with professional standards & regulatory requirements
- Discuss cost of service, insurance coverage, and payment options with the patient
- Obtain all prior authorizations for surgical procedures
- Place lab orders to facilitate pre-operative surgery requirement
- Meet with patients and families regarding procedures, medications, and continuing care
- Assist care team with setting goals for quality assurance and best practices
- Attend ongoing training and courses to keep abreast of new developments in health care
- Treat patients with empathy and respect while conducting oneself in a professional manner.
Patient Precertification Associate
Medstar Georgetown University Hospital – Dept Ob/Gyn
2015.04 - 2022.06
- Schedule and coordinate in-patient and out-patient surgical procedures for a 17-physician practice
- Complete appropriate CPT and ICD-10 coding to ensure reimbursement
- Counsels self-pay and insured patients pre-operatively regarding potential financial obligations
- Audit clinical notes to ensure validation of correct CPT and ICD-10 codes
- Manage and prepare bank deposits
- Audit accounts and statements to ensure proper billing collections
- Directly serve as a liaison between patients, healthcare providers and external organizations to facilitate care coordination
- Appeal to insurance companies for denials and underpayment of claims
- Prepare written materials and communicate policies clearly and concisely
- Obtain benefit verification for Specialty medications like IUD, Nexplanon, Evenity and Forteo
- Maintain and update surgery schedules several times per day
- Obtain authorization and benefits for Nexplanon, Mirena, Lupron and Gardasil
- Analyze operational data to improve processes such as surgical scheduling, medication ordering and medical device distribution.
Patient Account Representative
Medstar Georgetown University Hospital – Dept of OB/Gyn
2004.10 - 2015.04
- Verified patient insurance eligibility to necessitate reimbursement
- Coordinated supporting documents to ensure validity for services billed
- Facilitated the accurate and timely processing of charges
- Obtained necessary referrals needed to complete the billing process
- Ensured accurate CPT and ICD-10 coding while preparing fee tickets for charge entry and billing
- Obtained necessary referrals and authorization needed to complete the billing process
- Negotiated payment arrangements and assisted patients with financial hardship assistance information
- Completed FMLA and disability forms to ensure timely leave payments
- Ability to operate in multiple programs within Hospital systems
- Demonstrated personal and professional integrity
- Participate in peer audits and training.
Education
Prince George’s Community College
08.2020
Medical Billing Specialist
06.2017
Bachelor of Science Business Administration -
University Of Maryland Global Campus
05.2014
Skills
- Microsoft Office Suite: Word, Excel, Outlook
- Medical Terminology
- Billing & Coding
- Various computer systems including:
- IDX Registration/SMS Hospital Registration
- Centricity Electronic Medical Record System
- Cerner
- MedConnect
Timeline
Confidentially manage patient accounts
Medstar Georgetown University Hospital – Department of Urology
2022.06 - Current
Patient Precertification Associate
Medstar Georgetown University Hospital – Dept Ob/Gyn
2015.04 - 2022.06
Patient Account Representative
Medstar Georgetown University Hospital – Dept of OB/Gyn
2004.10 - 2015.04
Prince George’s Community College
Medical Billing Specialist
Bachelor of Science Business Administration -
University Of Maryland Global Campus
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