Carmen Lewis
Duncanville,Texas
Summary
To seek and maintain full-time position that offers professional challenges. I am organized and a dependable candidate, with a positive attitude, and ready to be a team player.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Insurance Verification/Pre-Certification Spec.
Baylor Scott & White Cancer Center
04.2019 - Current
- Verify commercial, Medicare, Medicaid insurance via phone, web portals or EPIC medical database system.
- Obtain pre-certification for chemotherapy, radiation therapy, radiology( CT's, MRI's, Pet scans).
- Document all verification and pre-cert information into EPIC medical database system in a timely manner.
- Answer in-coming calls from patients and insurance companies regarding insurance questions.
Insurance Verification Specialist
Surgical Care Affiliates
01.2016 - 01.2019
- Verify commercial, Medicare, and Medicaid via phone, web portal or HST system.
- Verify outpatient surgical procedures for Ambulatory Surgical Centers and physicians' offices, confirming all necessary pre-cert or auth info received
- Contact patients to explain and collect surgery fees.
- Post payments and payment plans into Zirmed and Waystar revenue cycle collection systems.
- Document all insurance verifications, patient responsibilities, and any payment info into HST medical database.
Patient Advocate
First Choice Emergency Room
06.2015 - 01.2016
- Answer in-coming calls from patients and insurance providers regarding billing
- Process and post payments, set up payment plans and provide financial counseling to patients on outstanding balances
- Educate patients regarding their insurance benefits and company billing policy
- Document all calls and financial agreements into Centricity medical database.
Insurance Verification/Pt Registration Lead
Convergent
10.2011 - 01.2015
- Verify commercial and Medicare insurance via phone or web portals.
- Verify in-patient and out-patient surgery for Hospital facilities.
- Verify out-patient radiology and nuclear medicine for Hospital facilities.
- Obtain all pre-cert and authorizations from physician office, web portal or phone.
- Contact patients to pre-register, collect demographic/insurance information, and inform patient of out-of-pocket costs.
- Enter all patient information into AS-400 medical database.
Insurance Verification Coor
Forest Park Medical Ctr
08.2009 - 04.2011
- Oversaw insurance verification of all in-patient and out-patient surgical procedures.
- Ensured all mandatory authorizations were on file in a timely manner and reported in Meditech medical database.
- Maintained relationships with facility nurse case manager and physician offices regarding surgical cases if patient is admitted.
- Informed patients of their co-pay, deductible, and out-of-pocket charges.
Patient Coordinator
Renaissance Hospital
08.2007 - 05.2009
- Manage front desk on clinic days, collect payments, verify insurance, obtain pre-certifications for surgical procedures.
- Prepared patients for bariatric surgery, answer multi-line phone system, data entry, chart preparation, and documenting medical notes.
- Schedule patients for sleep studies, psych exams, lab exams, and physician appointments.
Education
Medical Office Assistant -
PCI Health Training Institute
Irving, TX08.2007
Office Management -
Hartford Community College
Hartford05.2005
Skills
- Knowledge of commercial and Medicare/Medicaid insurance and terminology Verifying PPO, HMO, EPO, Worker's Compensation, Medicare and Medicare HMO/Replacement, Medicaid/Medicaid HMO
- Familiar verifying in and OON network facilities and physicians
- Experience with medical databases such as EPIC, Centricity, HST, SIS, Meditech
- Understanding of Medicare and commercial insurance web portals
- Proficient with HCPCS, CPT, and ICD-10 codes
- Positive attitude, great team player, dependable, fast learner
Certification
- Medical Office Assistant Training - 2007
Timeline
Insurance Verification/Pre-Certification Spec.
Baylor Scott & White Cancer Center
04.2019 - Current
Insurance Verification Specialist
Surgical Care Affiliates
01.2016 - 01.2019
Patient Advocate
First Choice Emergency Room
06.2015 - 01.2016
Insurance Verification/Pt Registration Lead
Convergent
10.2011 - 01.2015
Insurance Verification Coor
Forest Park Medical Ctr
08.2009 - 04.2011
Patient Coordinator
Renaissance Hospital
08.2007 - 05.2009
Medical Office Assistant -
PCI Health Training Institute
Office Management -
Hartford Community College
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