BRENDA MCLOUTH
Clarkston,MI
Summary
CONTACT Hardworking, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs and increase service value.
Overview
18
18
years of professional experience
Work History
Provider Engagement Specialist ACO/PO
CCA Health ACO (formally Reliance ACO)
Farmington Hills, MI
06.2020 - Current
- Completed and record findings of medical record inspection process, collaborating with quality team members and department managers to implement procedural remedies
- Liaison between company and physician practices.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems
- Educate providers and staff on the changes of metric qualifications from CMS to help close gaps in care
- Track and monitor gap closures reported by practices through medical record reviews
- Build a working relationship with providers and staff to help with education and reviews
- Prepared working papers, reports and supporting documentation for audit findings
- Maintained up-to-date knowledge of changes to metrics in CMS yearly guide
- Conduct hospital record searches for records to help close gaps of care
- Communicated audit and quality review results and recommendations through written reports and face-to-face meetings.
- Collaborated with internal teams to ensure successful implementation of initiatives designed to improve customer experience.
- Created reports summarizing key performance metrics related to customer engagement activities.
Medical Receptionist/Office Manager/Insurance Verification Specialist
McLaren Oakland Pain Management
Clarkston, MI
08.2016 - 06.2020
- Ensured insurance payments for medical procedures.
- Reduced lost income for the hospital and physician by preparing documentation for insurance coverage
- Improved office flow.
- Trained front office staff.
- Resolved billing problems.
- Monitored prior authorizations for the office.
- Effectively controlled the release of proprietary and confidential information
- Prepared appeals for medical claims.
- Managed all appeals and grievances for the office.
- Maintained patient privacy and confidential patient information.
- Organized, updated and maintained over 400 patient charts.
- Provided support to clinical staff during patient visits, including rooming patients, collecting vital signs and documenting chief complaints.
- Performed data entry tasks related to billing and collections procedures.
- Processed referrals for specialist care when requested by physicians or patients.
- Trained new staff on office procedures, insurance processes and medical terminology.
- Conducted patient intake interviews to collect medical information and insurance details.
- Assisted with the preparation of budgets, forecasts and financial statements.
- Developed and implemented office policies and procedures.
Office Manager/Physician Secretary
Henry Ford West Bloomfield Hospital
West Bloomfield, MI
11.2006 - 02.2010
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Coordinated patient scheduling, check-in, check-out and payments for billing
- Typed memos and letters using standard computer or word processor
- Backed up and assisted with clerical or technical tasks, driving operations during staff absences
- Provided typing, word processing and clerical support and assisted with special projects
- Displayed pleasant and professional voice and demeanor, positively representing organization
- Effectively controlled the release of proprietary and confidential information
- Consulted and scheduled members of large companies for visits and injections to the travel clinic
- Solved billing matters for patients.
- Reduced spending to help meet the clinics budget.
- Over saw and managed physicians schedules.
- Set up appointments for physician visits and procedures using calendar software
- Processed patient payments and scanned identification and insurance cards
- Observed strict HIPAA guidelines at all times according to company policy
- Handled all office supply ordering including ink cartridges, toner and paper
- Communicated with all partners throughout the practice including physicians, nursing staff, technicians and medical assistants
- Ensured that the phone was answered by the second ring and enthusiastically greeted all callers
- Took messages from patients and relayed them to the appropriate staff.
- Developed and implemented office policies and procedures.
Lead Medical Receptionist
Clarkston Medical Group
Clarkston, MI
09.2005 - 11.2006
- Processed patient payments and scanned identification and insurance cards
- Set up appointments for physician visits and procedures using calendar software
- Observed strict HIPAA guidelines at all times according to company policy
- Ensured that the phone was answered by the second ring and enthusiastically greeted all callers
- Entered patient information including insurance, demographic and health history into the system to ensure that all records were up-to- date
- Took messages from patients and relayed them to the appropriate staff
- Typed reports and correspondence, fostering internal and external communication
- Scanned and documented new patient information in electronic health records for registration purposes
- Used basic knowledge of medical terminology in daily office tasks.
- Performed bookkeeping duties, such as credits and collections, preparing and sending financial statements and bills and keeping financial records.
- Assisted physicians with patient care by taking vital signs, patient histories and preparing patients for examinations.
- Administered injections, medications and treatments as directed by the physician.
- Prepared laboratory specimens for analysis and organized lab results for review by the physician.
- Maintained accurate medical records through filing, charting, transcription and data entry into electronic health record system.
- Educated patients on healthcare topics such as nutrition and disease prevention methods.
- Conducted EKGs, spirometry testing, audiograms and other diagnostic tests as requested by the physician.
Education
High School Diploma -
Brandon High School
06-1993
Some College (No Degree) - Medical Insurance Coding/Medical Insurance Billing
Mott Community College
Some College (No Degree) - Health Management And Clinical Assistance
Baker College
Skills
- Microsoft Office
- Audit Assistance
- Knowledgeable of ACO and CMS rules and regulations
- Data Capture and Analysis
- Excellent verbal and written skills
- Solution oriented
- Building strong relationships with clients
- Computer proficient
- Excellent organizational skills
- File/records maintenance
- Ability to think strategically and creatively in decision making
- Materials Development
- Problem-Solving
Timeline
Provider Engagement Specialist ACO/PO
CCA Health ACO (formally Reliance ACO)
06.2020 - Current
Medical Receptionist/Office Manager/Insurance Verification Specialist
McLaren Oakland Pain Management
08.2016 - 06.2020
Office Manager/Physician Secretary
Henry Ford West Bloomfield Hospital
11.2006 - 02.2010
Lead Medical Receptionist
Clarkston Medical Group
09.2005 - 11.2006
High School Diploma -
Brandon High School
Some College (No Degree) - Medical Insurance Coding/Medical Insurance Billing
Mott Community College
Some College (No Degree) - Health Management And Clinical Assistance
Baker College
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