Carlanda Eddington
Houston
Summary
A meticulous, organized, focused and self-motivated individual who excels in prioritizing working and completing multiple tasks simultaneously, and providing great customer care. Experienced in a wide range of front office services, including but not limited to insurance verification, patient registration, maintaining office accounts, collecting patient insurance information, collecting patient demographics, answering phones, scheduling, discussing financial arrangements with patients. A proven track record delivering exceptional quality customer service and building relationships. Patient-driven, patient-focused, results-oriented, with a passion for service excellence.
Overview
11
11
years of professional experience
Work History
Senior Patient Access Representative
UT Health Of Houston
2021.08 - Current
- Streamlined registration processes for increased efficiency and reduced wait times.
- Improved patient satisfaction by providing timely and accurate appointment scheduling.
- Conducted regular audits of patient accounts to maintain accuracy, minimize errors, and prevent revenue loss due to incorrect billing practices.
- Assisted patients in understanding their financial responsibilities, promoting transparency and trust between the facility and its clientele.
- Reduced insurance claim denials by diligently verifying patients'' insurance coverage and eligibility.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations, protecting privacy rights at all times.
- Managed high call volumes while maintaining exceptional customer service standards for patients and healthcare providers alike.
- Collaborated with clinical staff to ensure seamless coordination of care, resulting in improved patient outcomes.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Providing excellent customer service by promptly answering patient inquiries.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Answered incoming calls, scheduled appointments and filed medical records.
- Verified patient insurance eligibility and entered patient information into system.
- Greeted and assisted patients with check-in procedures.
- Facilitated communication between patients and various departments and staff.
- Responded to inquiries by directing calls to appropriate personnel.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Delivered support to medical staff in completion of patient paperwork.
PATIENT ACESS REPRESENTATIVE III TEAM LEAD
Memorial Hermann Health System
2020.08 - 2021.07
- Responsible for mentoring other employees as a team leader
- Patient registration, admission and discharge of patients
- Ensuring medical necessity compliance
- Explains all required forms to patient or guarantor and obtains the necessary signatures
- Verifies insurance eligibility and benefits
- Obtains demographic, insurance and financial information from patient
- Enters information in computer system with a high degree of accuracy
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency
- Serves as preceptor, mentor and resource to less experienced staff
- Functions as a team leader in the department by ensuring daily processes are complete, providing answers to employee questions and assisting in employee orientation and training.
FRONT OFFICE RECEPTIONIST
Dr. Stan Shelton DDS, MAGD
2019.06 - 2020.08
- Register new patients (greet patients, assist patients to complete all necessary paperwork and verify and update patient information)
- Maintain a full schedule of patients daily
- Coordinate financial agreements for the patient's financial responsibility of dental treatment
- Calculate fees for dental treatment
- Assist patients with understanding and accepting their clinical diagnosis
- Check and respond to voicemails and emails left for the office
- Prepare claim form for dental insurance and arrange supporting documents for insurance claims
- Prepare and mail patient billing statements
- Assist with treatment room as needed
- Verifies and activates appropriate patient insurance plan
- Manages patient account balances appropriately to include pre-collections, old balances and same day services.
FRONT OFFICE RECEPTIONIST
Dr. Perry Wood DDS
2017.07 - 2019.06
- Composed and regulate all schedules for provider treatment patient in clinic
- Developed monthly and quarterly analysis of cash, bad debt reserve
- Collections, Billing, Customer Service, Receivables, System Administration and Cash Posting
- Completion of Balance Transfers
- Review and Implementation of Financial Options
- Coordination and Review of Treatment Plan
- Coverage and Insurance Verification
- Referral and Surgery Pre-Authorizations.
HOSPITAL FINANCIAL ACCESS SPECIALIST
University Hospital
2016.10 - 2017.07
- Maintained financial clearance for the hospitals Wound Care Clinic and Pediatric and Adult ENT Clinic
- Maintained knowledge of applicable rules, regulations, policies, laws and guidelines for Medicaid and Medicare
- Responsible for Financial Clearance for admitted patients
- Level of Benefits Determination, Coordination of Benefits
- Primary and Coinsurance Insurance Verification
- Performed Pre-Certification and Referral Coordination respective to patient care
- Responsible for review of patient finances and financial counseling
- Accounts payable and receivable
- Comprehensive quality assessments of clinical and administrative data relating to patient care
- CPT and ICD-10 Code Verification.
REGISTRATION ACCESS SPECIALIST
University Hospital
2013.07 - 2016.10
- Responsible for Interviewing patients to obtain patient information, insurance coverage
- Patient Registration, Admission and Discharge of patients
- Review and Implementation of Financial Options
- Processing of Pre-Care documentation based on Insurance Requirements
- Verification of Insurance Coverage
- Regulate schedules for Providers treating patients in Emergency room, Radiology, Orthopedic, and Trauma Follow-up and Wound Care Departments.
Education
Associate of Science -
Lone Star College System
Cypress, TX05.2024
High School Diploma -
Judson High School
San Antonio, Texas01.2005
Skills
- Proficient in Microsoft office (Word, Excel, PowerPoint, Outlook), Scheduling, Financial Planning, Accounts Payable, Accounts Receivable, Surgery Pre-Certification, Denial Management, Billing and Compliance, Insurance Verification, Customer Service.
- HIPAA Compliance
- Medical billing knowledge
- Patient Registration Expertise
- Problem-Solving
- Multitasking and Organization
- Money Handling
- Patient check-in
- Registration and Admissions
- Phone and Email Etiquette
- Calm and Effective Under Pressure
- Punctual and Hardworking
- Caring and Empathetic
Timeline
Senior Patient Access Representative
UT Health Of Houston
2021.08 - Current
PATIENT ACESS REPRESENTATIVE III TEAM LEAD
Memorial Hermann Health System
2020.08 - 2021.07
FRONT OFFICE RECEPTIONIST
Dr. Stan Shelton DDS, MAGD
2019.06 - 2020.08
FRONT OFFICE RECEPTIONIST
Dr. Perry Wood DDS
2017.07 - 2019.06
HOSPITAL FINANCIAL ACCESS SPECIALIST
University Hospital
2016.10 - 2017.07
REGISTRATION ACCESS SPECIALIST
University Hospital
2013.07 - 2016.10
Associate of Science -
Lone Star College System
High School Diploma -
Judson High School
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