Briana Gregoire
Medical Office Administration
Arlington,Tx
Summary
Summary Profile A Medical Office Administrator with excellent customer services skills with the ability to multi-task, organize, prioritize and maintain productivity while learning new concepts and information.
Overview
6
6
years of professional experience
2
2
years of post-secondary education
Work History
Health Information Specialist I
Ciox Health LLC, Texas Health Hospital Mansfield
Mansfield, TX
10.2022 - 04.2023
- Associate must at all times safeguard and protect the patient’s right to privacy by ensuring that only authorized individuals have access to the patient’s medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations
- Receive and process requests for patient health information in accordance with Company and Facility policies and procedures
- Maintain confidentiality and security with all privileged information
- Maintain working knowledge of Company and facility software
- Adhere to the Company's and Customer facilities Code of Conduct and policies
- Inform manager of work, site difficulties, and/or fluctuating volumes
- Assist with additional work duties or responsibilities as evident or required
- Consistent application of medical privacy regulations to guard against unauthorized disclosure
- Responsible for managing patient health records
- Responsible for safeguarding patient records and ensuring compliance with HIPAA standards
- Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record
- Ensures medical records are assembled in standard order and are accurate and complete
- Creates digital images of paperwork to be stored in the electronic medical record
- Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately
- Answering of inbound/outbound calls
- May assist with patient walk-ins
- May assist with administrative duties such as handling faxes, opening mail, and data entry
- Must meet productivity expectations as outlined at specific site
- May schedules pick-ups
- Other duties as assigned
Patient Service Specialist
Select Medical, Baylor Scott & White Institute Rehabilitation
Fort Worth, Tx.
05.2022 - 09.2022
- The Patient Services Specialist , with direct oversight, provides administrative support in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care
- Assists with patient duties to include patient relations, check-in or check-out, scheduling, insurance verification, and answering phones
- Arranges follow-up visits and referral appointments
- Assists with patient registration duties by collecting and verifying insurance information
- Verifies patient demographics and enters changes into computer system
- Directs patient to appropriate waiting areas
- Accepts payments for physician/clinic services according to established guidelines
- Posts payments and enters charges into computer utilizing appropriate codes
- Generates daily payment reports and verifies cash drawer against report
- Provides accurate patient, medical, financial or procedural information to patients or approved outside entities
- May be required to discuss financial arrangements with patients
- Receives and directs phone calls
- Assists patients and other visitors
- Responds to routine inquiries concerning practice services, hours of operation, etc
- Ensures any patient complaints are handled appropriately
- Assists with medical records duties as requested
- Collects revenue for past due balances
Quality Documentation specialist
Nuance Communications
07.2021 - 05.2022
- Provide documentation coverage for a set of healthcare providers, which involves listening to audio recordings of patient clinic visits and leveraging technology to summarize medical facts in professional clinical reports (History of Present Illness, Physical Exam, Results, Assessment & Plan)
- Achieve proficiency in navigating EHRs and enter clinical reports and data directly into customer EHRs, adhering to specific clinic guidelines and workflows
- Maintain a high-quality standard and adhere to account-specific documentation which delineates documentation requirements for our customers
- Collaborate with managers on feedback from providers and successfully resolve issues.
Park Manor Rehabilitation Center
07.2019 - 08.2021
- Medical Records filing paperwork duties
Pharmacy Care Coordinator
Spectraforce technologies
Frisco, TX
06.2020 - 06.2021
- Assists the patient by coordinating their prescribed pharmacy care with the patients’ health care providers, payers, and other health related resources to ensure successful drug therapy outcomes and demonstrate value to patients, healthcare providers and payers
- Answers and resolves patient inquiries within committed time frames
- Understands the physical, psychological and social challenges of specific disease states and assists the patient with drug therapy and pharmacy care issues
- Promotes drug compliance
- Reports all adverse events related to drug therapy and pharmacy care
- Establishes and maintains strong customer relationships with physician practices to streamline communication to the patient, payers, pharmacist, nurse, lab and other healthcare related parties
- Participates in Administration of patient's pharmacy care plan
- Troubleshoots and resolves patient and payer issues in a timely fashion
- Works in a team-structured environment to provide support to other members of the healthcare team
- Embraces a continuous quality improvement customer service approach by pro-actively identifying areas of improvement and communicating those ideas to the healthcare team
- Maintains current notes and documentation related to patient's drug therapy and pharmacy care plan; flags issues that need to be addressed
- Coordinate’s responses and resolutions with appropriate internal and external parties
- Actively participates in discussions with pharmacists, nursing services, pharmacy support manager and other pharmacy care coordinators to review cases and related drug therapy and pharmacy care plan issues
- Performs related duties as assigned
- Strong time management, organizational skills, initiative, professional demeanor and positive attitude
- Attention to detail, quick study, self-motivated, proactive, and the ability to work independently with a high degree of initiative Ability to communicate effectively both orally and in writing
- Ability to promote a positive team environment
- A champion for excellence, efficiency and quality
- Ability to collaborate with other professionals within the organization Strong interpersonal skills
- Taking inbound & outbound calls daily (100 + calls)
- Answering patient questions on Prescription refills (20 calls)
- Handling patient EMR
- Scheduling appointments
- Lab Data entry
- Parkland Hospital
- Registering patients covid 19 samples in the system
- Working with over 200 plus patients and information
- Dealing with the EPIC software/system
Billing Coordinator/data entry
Mint Dentistry
Irving, Tx
11.2019 - 06.2020
- Ensures all monies due from insurance companies and patients are collected
- Prints and inspects all aging and adjustment reports for accuracy
- Edits any adjustment discrepancy
- Sends supplemental claims when required
- Reports to Supervisor errors when found and when claims are reopened for possible reimbursement
- Tracing/ insurance collection
- Track’s progress of re-submitted claims for possible reimbursement
- Relentlessly pursues unpaid claims, continuously updates claims status, and addresses all correspondence issues
- Resubmits claims, Submits corrected claims, and/or any additional information missing from the original claim
- Notates reference numbers and dental insurance representatives’ names
- Contact patients to engage them in collecting unpaid claim payments and sends billing statements in cases warranted
- Ensures member, payor identification, date of birth, and mailing address are all correct on claims and patient accounts
- Ensures all electronic funds transfer (EFT) payments are posted and recorded within the patient accounts
- Scans denied EOBs, insurance correspondence, and letters to patients’ accounts
- Notates all findings while working adjustments or aging
- Audit every claim by appointment on the schedule to ensure it was submitted correctly
- Audit every payment posted and write off created
- Audit all aging reports and status updates notated by their team
- Audits the EDS Rejected Claims report
- Audits completed appointments to ensure proper claim submission
- Reviews x-rays, perio charts, and clinical notes to select narratives and images for insurance claims attachments
- Submits pre-authorization and insurance claims electronically and/or if necessary, via fax/mail
- Pays close attention to details when submitting in and out of network claims
- Audits other teams claim submissions to ensure all claims are sent correctly
- Runs Rejected Claims and Outstanding Claims reports and pursues all claims listed
- Works with Open Dental, NEA and EDS Software
- Contacts insurance companies and updates on claim status notes
- Passes all claims that need to be re-submitted to the submitting lead
- Submits all necessary reports required for tracking progress
- Trains with Team Lead during down time
- Locates insurance EFT and virtual credit card (VCC) payments from online portals
- Posts insurance check, EFT, and VCC payments to the patients accounts on itemized claims
- Prints and assigns secondary claims to the submissions team
- Adjusts and applies patients balances under the correct adjustment categories
- Balances insurance check, EFT, merchant processor, and financing payments
- Uses critical thinking skills to ensure all money is collected for every procedure
- Scans denied and paid eligibility of benefits (EOBs), insurance correspondence, and letters to patients’ accounts
- Completes office Daily Deposit report and sends to Accounts Receivable (AR)
Call Center Agent/Customer service
Holiday Inn Club Vacation
Pantego, TX
03.2019 - 11.2019
- Taking inbound calls on a multi-line phone system
- Warm calling
- Sales
- Handling current customer accounts electronically
- Scheduling appointments
Life Insurance Agent/Data
American Income Life
Arlington, TX
04.2017 - 03.2019
- Entry
- Handling Customer Inquiries Face to Face and over the phone
- Organizing personal information electronically and paper form
- Sales
- Appointment scheduling
Education
High School Diploma -
Judson Learning Academy
San Antonio, TX 10.2015 - 06.2016
Medical Office Administration Diploma - Medical Office Administrator
Concorde Career College
Grand Prairie, TX 05.2019 - 06.2020
Bachelors - HealthCare Administration
University of Phoenix
Dallas, TX 01.2023 - Current
Skills
Qualifications/Skillsundefined
Timeline
Bachelors - HealthCare Administration
University of Phoenix
01.2023 - Current
Health Information Specialist I
Ciox Health LLC, Texas Health Hospital Mansfield
10.2022 - 04.2023
Patient Service Specialist
Select Medical, Baylor Scott & White Institute Rehabilitation
05.2022 - 09.2022
Quality Documentation specialist
Nuance Communications
07.2021 - 05.2022
Pharmacy Care Coordinator
Spectraforce technologies
06.2020 - 06.2021
Billing Coordinator/data entry
Mint Dentistry
11.2019 - 06.2020
Park Manor Rehabilitation Center
07.2019 - 08.2021
Medical Office Administration Diploma - Medical Office Administrator
Concorde Career College
05.2019 - 06.2020
Call Center Agent/Customer service
Holiday Inn Club Vacation
03.2019 - 11.2019
Life Insurance Agent/Data
American Income Life
04.2017 - 03.2019
High School Diploma -
Judson Learning Academy
10.2015 - 06.2016
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