Enthusiastic medical receptionist offering 2+ years of experience in communicating positively with physicians, office staff, and patients. Polished, hard worker and willing to go extra mile to complete any task. Dynamic Precertification Specialist with experience in coordinating insurance approvals and educating patients. Skilled in maintaining accurate records and resolving discrepancies, contributing to efficient healthcare operations and improved patient outcomes.
Overview
15
15
years of professional experience
Work History
Precertification Specialist
TriState Orthopedic Surgeons
Evansville, IN
09.2023 - Current
Reviewed patient insurance eligibility for orthopedic procedures and services.
Coordinated precertification requests with insurance providers for timely approvals.
Communicated with medical staff regarding necessary documentation for precertification.
Maintained accurate records of precertification requests and statuses in systems.
Followed up on pending precertification requests to ensure prompt responses.
Educated patients about precertification processes and required information.
Collaborated with healthcare teams to streamline the precertification workflow.
Resolved discrepancies in insurance information to facilitate approval processes.
Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
Collaborated with other departments within the organization as needed to resolve issues or obtain additional information.
Assisted with answering provider inquiries regarding preauthorization requirements and processes.
Compiled and submitted precertification requests for review by payers in accordance with established timelines.
Maintained detailed documentation of all activities related to the precertification process.
Resolved any discrepancies identified during the precertification process.
Processed appeals when necessary following denial or rejection of claims due to lack of proper authorization.
Medical Receptionist
Wabash General Hospital
Mount Carmel, IL
03.2019 - 09.2023
Conducted patient intake interviews to collect medical information and insurance details.
Answered phone calls to provide assistance, information and medical personnel access to maximize office efficiency.
Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services.
Updated group medical records and technical library to support smooth office operations.
Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
Observed strict HIPAA guidelines at all times according to company policy.
Processed patient payments and scanned identification and insurance cards.
Straightened up the waiting room so that it remained neat and organized.
Communicated with all partners throughout practice, including physicians, nursing staff, technicians and medical assistants.
Took messages from patients and promptly relayed to appropriate staff.
Informed patients of financial responsibilities prior to rendering services.
Pleasantly greeted each patient and offered the desk sheet for easy sign-in.
Entered patient information including insurance, demographic and health history into the system to keep all records up-to-date
Greeted callers with enthusiasm, answering all phone calls by second ring.
Answered multi-line phone system and directed callers to requested personnel and departments.
Medical Assistant
Tri-State Orthopaedics & Sports MedicineInc
Evansville, IN
01.2016 - 07.2017
Conducted patient interviews to gather health history, vital signs and information about current medical issues.
Assisted physicians by preparing patients for procedures, including EKGs, phlebotomy, glucose testing and pulmonary function tests.
Transmitted physician's orders to patients, counseling on execution and addressing follow-up questions.
Sterilized medical instruments to streamline procedural use.
Identified operational improvements to drive efficiency and quality of care.
Contributed to efficient office operations by triaging patients by severity of medical complaint.
Communicated with medical transcriptionists regarding patient medical records.
Partnered with healthcare and administrative staff to create patient-centered, inviting and supportive environment for patients and families.
Kept facility stocked with necessary supplies, equipment and instruments.
Trained patients on how to properly operate medical equipment.
Assisted patients in preparation for examinations, assessing and recording vital signs.
Sterilized instruments and disposed of contaminated supplies in adherence to OSHA regulations.
Escorted patients to examination rooms and documented medical histories.
Prepared patients for examinations, taking vital signs and updating medical histories.
Recorded patient histories and filed supporting clinical data and diagnosis.
Interviewed patients to verify information, record medical history and confirm purpose of visit.
Selected equipment for use in ultrasound setup according to specifications of examination.
Contacted pharmacies to submit and refill patients' prescriptions.
Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
Tracked and managed inventory for exam rooms and maintained vaccine and expiration logs.
Sterilized medical equipment after each procedure.
CNA
Richland Memorial Hospital
Olney, IL
06.2011 - 01.2016
Documented patient intake and dietary requirements, also assisting with feeding and monitoring.
Responded to patient alarms and needs-assessment requests to identify course of treatment.
Conducted routine checks on standard patient vitals, including blood pressure, blood sugar and heart rate.
Documented activities and recorded information in EMR system.
Assisted patients with shaving, bathing and oral hygiene to promote healthy habits and overall wellness.
Used mobility devices equipment to transport patients.
Facilitated activities of daily living, including personal hygiene management, feeding and ambulation.
Exhibited compassionate care and communication regarding issues surrounding death and dying.
Engaged with patient family and friends to provide courteous, efficient visit experience.
Examined and addressed lacerations, contusions and physical symptoms to assess and prioritize need for further attention.
Consulted with nurses to develop patient care plans and evaluate treatment options.
Collected specimens, monitored vitals and maximized patient comfort to maintain optimal environment.
Managed and maintained patient rooms, shared-living areas and nursing stations.
Education
Associate of Science - Associate of Science And Arts
Wabash Valley College
Mount Carmel, IL
05.2010
High School Diploma -
Edwards County High School
Albion, IL
05.2009
Skills
HIPAA guidelines
Appointment scheduling
Front desk operations
Records maintenance
Customer service
Telephone etiquette
Technologically savvy
Organization
Patient callbacks
Working collaboratively
Reliable and trustworthy
Positive demeanor
People skills
Insurance verification
Precertification processing
Insurance verification expertise
Timeline
Precertification Specialist
TriState Orthopedic Surgeons
09.2023 - Current
Medical Receptionist
Wabash General Hospital
03.2019 - 09.2023
Medical Assistant
Tri-State Orthopaedics & Sports MedicineInc
01.2016 - 07.2017
CNA
Richland Memorial Hospital
06.2011 - 01.2016
High School Diploma -
Edwards County High School
Associate of Science - Associate of Science And Arts