Dynamic individual with hands-on experience and talent for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.
Overview
16
16
years of professional experience
Work History
Pre Service Adm Associate
Honor Health Hospital
Phoenix, AZ
08.2022 - Current
Works accounts from assigned WQ, confirm correct insurance plan was encoded on account, update if needed.
Faxes inpatient or observation notification of admission to payors utilizing appropriate method ensuring payor requirements are met for admission notification and documenting the EMR/EPIC appropriately according to department standards.
Communicates with Admitting Services Intake Counselors if patient’s coverage is termed or if unable to determine correct coverage with payor information obtained at time of admission.
Continuously monitors deferred and pending authorization accounts and follows up appropriately and timely with payor for authorization.
Notifies payor/plan when patient class changes, ensuring auth is reflecting the appropriate patient class.
Ensures the Bed Days form is completed accurately, when applicable
Communicates appropriately with Case Management/UR nurses for clinicals requested by payor or admission authorization denials from payor by following defined workflow and documenting EPIC/EMR appropriately according to department standards.
Monitors OnBase daily for incoming faxes from payors with authorization information, index documents to appropriate patient account, and document EMR/EPIC Auth/Cert according to defined workflow and department standards.
ER Admitting
United Health Group, Optum 360
Phoenix, AZ
09.2020 - 12.2021
Interviews patients to obtain all necessary account information
Verifies all insurance and obtain pre-certification/authorization Calculate and collect patient liable amounts
Ensures that all necessary signatures are obtained for treatments Answer any questions and explains policies clearly
Processes patient charts according to paperwork flow needs and established productivity standards
Obtains copies of necessary identification and insurance cards
Explains policies regarding services, charges, insurance billing, and payment of account
Requests full or partial payment for services rendered according to collection policies
Issues a Business Office letter to all patients according to policy
Collects co-pays, deposits, and deductibles and documents collection status in the system and chart
Financial Clearance Specialist
United Health Group, Optum 360
Phoenix, AZ
03.2018 - 09.2020
Pre-Registered Patient for all 5 Dignity health hospital
Verifies insurance eligibility and obtains benefits
Secures or verifies authorization and pre-certification
Review and verify component parts of medical records to ensure completeness and accuracy of diagnosis
Analyze medical record documentation diagnosis and procedure codes provided on physicians' order
Calculates patient's financial responsibility, and assets with payment plans
Follows appropriate processes and procedures to ensure accurate billing and timely processes
Collects and enters required data into the system with emphasis on accuracy of demographic and financial information in order to ensure appropriate reimbursement
Patient Access Registration II
United Health Group, Optum 360
Phoenix, AZ
01.2017 - 03.2018
Schedules and also cancel appointments as necessary
Enter charges correctly and collect appropriate payments also set up payment plans
Answers incoming as well as making outbound calls In regards to appointment surgery
Verifies patient demographics
Pre-Registered Patient for all 5 Dignity health hospital
Medical Billing Specialist
Arizona Retina Associates
Peoria, AZ
02.2014 - 07.2016
Review and entry of daily charges, modifiers and services
Processing and posting of payments, research and follow up on unresolved payment issues
Receive and initiate patient calls to resolve billing or payment concerns
Research, review and communicate with insurance carriers regarding open accounts receivables
Review HCFAs, edits for submission to insurance companies
Review, research and initiate collection procedures
Patient Access Representative
Sharp Healthcare
San Diego, CA
06.2009 - 12.2013
Communicating with patients and their families about the details of their bills and insurance restrictions
Providing patients with appointments, information and other operational support services
Provides a high level of customer service
Responsible for patient registration, demographic and insurance updates
Confirms insurance eligibility and obtains authorizations for service
Works with patients to resolve billing and insurance related issues