Organized and coordinated Healthcare Specialist with 15 years of experience in medical staff support. Proven expertise in authorization processes, billing & coding optimization, and clinical techniques. Highly skilled in EHR systems, documentation handling and insurance verification.
Overview
15
15
years of professional experience
Work History
Eligibility Representative
Accredo Health Group Inc
07.2022 - Current
Streamlined prescription processing with accurate data entry and verification of patient information.
Contributed to the reduction of prescription wait times by promptly addressing refill requests and insurance authorizations.
Expedited insurance claim resolutions by liaising with healthcare providers and insurance companies on patients' behalf.
Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
Optimized workflow efficiency through participation in regular team meetings discussing areas for improvement within the department.
Answered incoming phone calls and addressed questions from customers and healthcare providers.
Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
Certified Clinical Medical Assistant
Barrington Orthopedic Specialists
01.2011 - 03.2020
Enhanced patient care by efficiently performing clinical tasks such as taking vital signs and administering medications.
Improved patient flow within the clinic by effectively managing appointment scheduling and timely rooming of patients.
Assisted physicians in providing quality care through thorough documentation of medical histories and physical examination results.
Facilitated effective communication between patients and healthcare providers with clear explanation of medical procedures and treatment plans.
Managed inventory levels for medical supplies, ensuring appropriate stock was available for seamless clinic operations.
Maintained confidentiality of patient information by adhering to HIPAA guidelines at all times during recordkeeping and communications.
Certified Clinical Medical Assistant
Illinois Spine Institute
05.2009 - 01.2011
Verified patient insurance coverage and collected required co-payments.
Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Oriented and trained new staff on proper procedures and policies.
Liaised with patients and addressed inquiries, appointment requests and billing questions.
Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
Behavioral Health Care Coordinator in Utilization Management for Government Programs at Blue Cross and Blue Shield Illinois/HCSCBehavioral Health Care Coordinator in Utilization Management for Government Programs at Blue Cross and Blue Shield Illinois/HCSC