Dynamic Revenue Cycle Specialist with extensive experience at Prisma Health Upstate, adept at enhancing financial transaction oversight and improving patient satisfaction. Proven track record in process improvement and effective communication, successfully reducing claim denials and streamlining operations to maximize revenue. Committed to regulatory compliance and delivering exceptional customer service.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Revenue Cycle Specialist
Prisma Health Upstate
Greenville, SC
08.2023 - Current
Audited payments from third-party payers to ensure accuracy of reimbursement amounts.
Performed account reconciliations between insurance companies and internal systems.
Identified and corrected payment problems involving patients or third-party payers.
Produced accounting reports and provided targeted recommendations for improving revenue standing.
Reconciled monthly accounts receivable reports against system transactions.
Corporate Office Manager & Finance Associate
Island Global Yachting
Greenville, SC
06.2022 - 02.2023
Maintained 100% accuracy in processing Corporate invoices. Proficient at vendor management and thrives in challenging, fast-paced environments.
Opened new Office location and monitored up-lift changes to uphold successful operations strategies and maximize business success.
Streamlined and monitored processes to align with SEC requirements
Communicated with Marinas to ensure delivery of supplies to maintain high standard of customer service.
Streamlined and monitored quality programs to alleviate overdue compliance activities
Maintained professional demeanor by staying calm when addressing unhappy or angry customers
Managed senior-level personnel working in marketing and sales capacities
Patient Access Manager
Prisma Health Upstate
Easley, SC
10.2018 - 01.2021
Researched and implemented new processes, which helped to reduce number of claim denials, improve productivity, and increased Point of Service Collections.
Decreased patient wait times for registration and improved patient satisfaction
Scheduled team members to ensure clinical areas had support needed to register patients and verify insurance coverage.
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees..
Developed highly effective communication, interpersonal and active listening skills, which were used for interacting with people of all different backgrounds and cultures
Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
Discussed insurance eligibility with patients in effort to provide accurate estimate of patient services according to policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
Trained and mentored new employees in registration department, answered questions and provided insight on patient services.
Patient Access Team Lead
Palmetto Health Baptist Easley
Easley, SC
08.2014 - 09.2018
Resolved patient billing issues in line with established guidelines.
Offered simple, clear explanations to help patients and families understand their insurance policies and estimated out of pocket cost.
Developed Downtime process with Emergency Department Clinical Team. Process is 100% successful and eliminated rework.
Delivered support to medical staff in completion of patient paperwork.
Trained new staff on hospital processes and procedures.
Greeted and assisted patients with check-in procedures.
Provided excellent customer service to patients and medical staff.
Processed payments using cash and credit cards, maintaining accurate records of transactions.
Reviewed patient deductibles and liability amounts; discussed options to satisfy remainder of patient financial obligations.
Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
Financial Counselor
Palmetto Health Baptist Easley
Easley, SC
08.2011 - 09.2014
Assisted uninsured patients with financial options for their medical services.
Verified patient eligibility for financial assistance, and assisted patient in applying for any Federal or State programs that would assist patient.
Verified proper claim processing of insurance claims, and resolved any issues that were found.
Worked with patients to set up payment plans that was acceptable and fit their financial circumstances.
Resolved customer complaints using established follow-up procedures.
Engaged with patients to provide critical Financial information and ensure patient was informed based on their benefits.
Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Processed payments using cash and credit cards, maintaining accurate records of transactions.
Conducted interviews with patients and family members and answered questions regarding insurance benefits.
Stayed up-to-date on financial programs such as Medicaid, SNAP, Prescription Assistance, and other programs that would improve patients financial situation.
Established contact with 90% of uninsured patients that had overnight stays
Developed personal rapport with each patients to maintain customer loyalty and establish long-term accounts.
Patient Financial Counselor
Hospital Receibables
Easley, SC
08.2000 - 07.2011
Resolved customer complaints using established follow-up procedures.
Engaged with patients to provide benefit information according to their EOB ,explanation of benefits.
Delivered support to medical staff in completion of patient paperwork and financial clearance .
Worked claim issues with insurance to ensure proper payment was made timely.
Reviewed insurance EOB to establish patient liability.
Processed payments using cash and credit cards, maintaining accurate records of transactions.
First Team member to complete 100% account follow up