Summary
CBCS certified. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers 3+ years experience in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. CMAA certification will be completed by 2024.
Overview
12
12
years of professional experience
1
1
Certificate
Work History
Stay at Home Mom/Student
Texas A&M University Kingsville
03.2023 - 06.2024
- Work history gap due to being in school and full-time mom.
Patient Access Specialist
The University of Vermont Medical Center
05.2023 - 08.2023
- Provided exceptional customer service, addressing patient concerns promptly and professionally.
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
- Rooted out potential discrepancies in insurance claims submissions proactively preventing denials or delays in payments.
- Contributed to a positive work environment through effective teamwork and communication with colleagues.
- Maintained patient confidentiality by adhering to HIPAA guidelines and hospital policies.
- 90% and above on biweekly audits.
Patient Care Advocate
Care XM (Total Triage & TeleMed)
11.2021 - 03.2023
- Supported efficient scheduling practices by verifying patient eligibility and coverage prior to appointments.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Coordinated referrals to specialists, facilitating seamless continuity of care for patients with complex needs.
- Evaluated effectiveness of current strategies with interdisciplinary team and utilized recommendations to make permanent improvements to care standards.
- Experience with Call Corp, Microsoft Teams, Paycor, and Outlook.
- 95% of call evaluations score 100%.
Stay at home mom/homemaker
06.2016 - 10.2021
- Work history gap due to getting married and having a baby.
CNA - Certified Nursing Assistant
Little Rock Enrichment Center
07.2012 - 05.2016
- Provided effective pre-and post-operative care by preparing patients for surgery, monitoring vital signs, and assisting with pain management techniques.
- Promoted a safe and clean environment by maintaining strict adherence to infection control protocols and sanitation standards.
- Enhanced continuity of care by thoroughly documenting shift reports and maintaining clear communication with incoming staff members.
- EHR experience (eClinicalWorks, and NextGen).
- Scored above 95% on evaluations.
Call Center Representative II
First Arkansas Bank & Trust
01.2015 - 11.2015
- Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
- Mentored new hires as they navigated our systems and protocols, fostering teamwork within the call center.
- Identified upselling opportunities to increase revenue generation.
- General IT support resolving billing and software issues.
- 98-100% employee evaluations.
Senior Admissions Representative
Baptist Health Hospital
02.2012 - 04.2014
- Improved accuracy in documentation by diligently reviewing and verifying patient insurance information, demographics, and medical history.
- Provided exceptional customer service, assisting patients in understanding their insurance benefits and financial responsibilities.
- Verified patient insurance coverage and benefits for medical claims.
- Conducted thorough reviews of denied claims, identifying errors or missing information before resubmitting corrections for payment approval.
- Demonstrated adaptability during software transitions, quickly learning and teaching new systems to maintain productivity levels throughout implementation periods.
- Included systems: EPIC, ICD-9, CPT, Medicare, Medicaid, and commercial insurance.
Education
Training Program - Medical Billing And Coding
01.2024
- Relevant Coursework: Medical Terminology, Anatomy, and Physiology
- 3.7 GPA
Training Program in Medical Administration - Medical Administration
01.2024
- 3.9 GPA
High school diploma -
05.2011
- Professional Development: Work program for 2.5 years at Wendy's. Duties: Money management, customer service, crew training.
Skills
- Time management
- EMR systems
- Benefit interpretation
- ICD-10
- CPT
- Medical Billing
- Insurance Verification
- Revenue cycle management
- Medical Coding
- HIPAA Compliance
Certification
- CNA, Arkansas and Georgia, 03/01/12, 07/01/22
- CBCS, National Healthcare Association, 05/01/24, 05/01/26
Affiliations
- Military Spouse Club (Robins AFB) 2017 - Present
Timeline
Patient Access Specialist - The University of Vermont Medical Center
05.2023 - 08.2023
Stay at Home Mom/Student - Texas A&M University Kingsville
03.2023 - 06.2024
Patient Care Advocate - Care XM (Total Triage & TeleMed)
11.2021 - 03.2023
Stay at home mom/homemaker -
06.2016 - 10.2021
Call Center Representative II - First Arkansas Bank & Trust
01.2015 - 11.2015
CNA - Certified Nursing Assistant - Little Rock Enrichment Center
07.2012 - 05.2016
Senior Admissions Representative - Baptist Health Hospital
02.2012 - 04.2014
Texas A&M University - Kingsville - Training Program, Medical Billing And Coding
Texas A&M University - Kingsville - Training Program in Medical Administration , Medical Administration
North Pulaski High School - High school diploma,
Similar Profiles
Luke TrejoLuke Trejo
Tutor at Texas A&m University - KingsvilleTutor at Texas A&m University - Kingsville
Gabriel CavazosGabriel Cavazos
Supplemental Instructor at Texas A&m University - KingsvilleSupplemental Instructor at Texas A&m University - Kingsville
Cole PayneCole Payne
Community Exercise Outreach Intern at Texas A&M University - KingsvilleCommunity Exercise Outreach Intern at Texas A&M University - Kingsville
James Hester JrJames Hester Jr
Student Assistant Mentor at Texas A&m University - KingsvilleStudent Assistant Mentor at Texas A&m University - Kingsville
Amber CramerAmber Cramer
Stay at Home Mom/Student at Stay-At-Home MomStay at Home Mom/Student at Stay-At-Home Mom