CHERITA ROSS
Columbia,SC
Summary
Superior Financial and Quality Analyst Services; with many years of exceptional knowledge and experience. Continually exhibits the ability to maintain confidentiality and to think and act independently with minimal supervision. Relevant experience includes disciplined remote working, financial clearance, follow up and research on medical and disability claims; to also include billing initiation and denial resolution, quality analyzation, mortgage refinance and human resources. Dedicated to stellar written and verbal communication; plus excellent customer service skills. Highly adaptable in fast paced environments, very organized, a keen eye for detail and results driven.
Overview
11
11
years of professional experience
Work History
Patient Financial Services Coordinator
ATRIUM WAKE FOREST BAPTIST HOSPITAL
08.2017 - Current
- Prepare and complete correspondence for escalations, spreadsheets and special reports
- Analyze and resolve claims issues; including denials, credit balances, authorization, appeals and patient inquiries
- Notify customers of findings in accordance with department policies and procedures
- Receive and effectively respond to external provider related issues
- Analyze and apply medical, technical, contractual, and legal information to accounts to manage claims
- Teach and model effective claim practices to others.
- Facilitate communication between patients and internal departments for seamless coordination of financial services.
- Successfully manage high-priority projects under tight deadlines while maintaining focus on delivering exceptional results.
Financial Clearance-Revenue Cycle Specialist
BAY AREA HOSPITAL
08.2023 - 10.2024
- Responsible for ensuring accounts are financially cleared prior to service
- Reviewed electronic correspondence, records, reports, and research related files
- Maintained strong working knowledge of insurance plans, contract requirement and resources
- Determined if pre-certification, pre-authorization or referral is required by providing ICD-9 and CPT codes to the insurance company, facility or group
- Used utmost caution that obtained benefits, authorizations, and/or pre-certifications are accurate according to the actual test, and procedure or registration being performed to protect the financial standing of the facility
- Research billing and payment posting issues initiated by patients and/or insurance carriers
- Schedule patients for qualifying hospital services as needed.
- Increased revenue by identifying and resolving billing errors in a timely manner.
- Collaborated with cross-functional teams to improve overall financial performance of the organization.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
Quality Analyst, Client Service Coordinator, Verification/HR Specialist
MANAGED RESOURCE ASSIGNMENTS
09.2013 - 06.2017
- Responsible for review and final steps of mortgage refinance instruments for credit quality
- Clearly communicate overall transaction process quality and provide feedback to team members/leaders regarding identified material deficiencies or inconsistencies
- Conducted comprehensive research on transactions, individuals, organizations or locations to identify and mitigate associated sanctions, credit and financial crime
- Proven ability to interact with all levels of the organization
- Maintained a high level of familiarity with various medical insurance processes
- Provided prior authorization assistance and tracking
- Assist over 200 internal associates each month with human resource inquiries
- Responsible for processing invoices and issuing payments
- Assist new hires with orientations and benefit elections process
- Problem resolution of retirement plan, participant contributions and annuities
- Coordinated company meetings, counseling/services and arrange for specialized job training
- Collaborated with cross-functional teams to develop and implement targeted solutions for identified quality issues, ensuring continuous improvement.
- Maintained up-to-date knowledge of quality assurance methodologies, applying best practices to daily tasks.
Education
Associates Degree - Business
Western International University
Phoenix, AZMedical/Business Related Courses -
Kee Business College
Newport News, VAHigh School Diploma -
Greene Central High School
Snow Hill, NCSkills
- Epic
- Cerner
- OnBase
- NextGen
- WebEx
- Simplr
- Carelon
- NIA RadMD/Evolent
- OneSource
- One Health Port
- Microsoft Office: Word, Excel, PowerPoint, Outlook, OneDrive, OneNote, SharePoint, Teams
- Navigation of numerous Payer websites to include: VA Admin, MMIS, Availity, Noridian, BCBS, UHC, Humana, Cigna, etc
- Insurance Collaboration
- Payment Posting
- Records Coordination
- Coordinating Documents
- Revenue Cycle Management
- Financial Counseling
- Accounts Receivable Management
- Denial Management
- Medical Billing
- Analyzing Claims
- Excellent Communication
- Team Collaboration
Timeline
Financial Clearance-Revenue Cycle Specialist
BAY AREA HOSPITAL
08.2023 - 10.2024
Patient Financial Services Coordinator
ATRIUM WAKE FOREST BAPTIST HOSPITAL
08.2017 - Current
Quality Analyst, Client Service Coordinator, Verification/HR Specialist
MANAGED RESOURCE ASSIGNMENTS
09.2013 - 06.2017
Medical/Business Related Courses -
Kee Business College
High School Diploma -
Greene Central High School
Associates Degree - Business
Western International University
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