Claire Coleman
St. Petersburg,FL
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
13
13
years of professional experience
Work History
Patient Financial Navigator
Florida Cancer Specialists & Research Institute
Saint Petersburg , FL
2021.10 - Current
- Managed and obtained approvals for all aspects of Managed Care
- Demonstrated expertise in ICD-10 and CPT coding.
- Ensured consistent quality in eligibility and benefits verification every day
- Engaged in the daily task of initiating prior authorizations for treatment regimens, office visits, and imaging.
- Handled appeals for denied authorizations when necessary
- Reviewing EOB's to determine claims were processed correctly.
- Explained the various billing procedures and processes to patients.
- Provided guidance to patients regarding insurance coverage, payment plans, and available resources.
Insurance Eligibility and Authorization Coordinator
Bay Dermatology and Cosmetic Surgery
Saint Pete Beach , FL
2019.06 - 2022.10
- Obtained insurance authorizations for outpatient procedures as required.
- Maintained regular checks on patients' benefits and eligibility to ensure accuracy.
- Performed tasks with minimal guidance
- Resolved daily problems and insurance issues promptly.
- Researched information as necessary to resolve patient inquiries or issues with authorizations.
Customer Advocate/Benefit Value Advisor
HCSC Blue Cross and Blue Shield of Texas
Marshall , TX
2018.05 - 2019.05
- Demonstrated strong attention to detail by correcting and adjusting medical claims as required, ensuring accuracy of information.
- Resolved customer inquiries related to medical insurance plans, including eligibility, billing, and claims processing.
- Advised customers on how best to use their available benefits under their respective plans.
- Inputted data into the system, maintaining accuracy of provider coding information and reported services.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
Medical Office Receptionist and Billing Clerk
The Beverly Clinic
Longview , TX
2014.04 - 2018.05
- Provided information to patients regarding appointment scheduling, office hours, billing, and insurance policies.
- Handled confidential paperwork related to patient visits according to HIPAA regulations.
- Scheduled patient appointments, collected co-pays and verified insurance coverage.
- Submitted diagnosis and procedure codes for insurance companies.
- Managed all payments processing, invoicing and collections tasks.
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
- Cooperated with Medicare, Medicaid and private insurance providers to resolve billing issues.
Demographics Representative/Medical Records
EmCare/MedAssociates
Longview , TX
2013.01 - 2014.01
- My main duty as a Medical Record clerk was to request and gather miscellaneous medical records for 25 healthcare facilities for anesthesia billing.
- I worked independently and maintained an excellent production daily.
- Identified discrepancies between physical documentation and electronic health records.
- Assisted in the development of policies and procedures related to the maintenance of accurate medical records.
- Processed incoming medical records requests.
- Performed quality assurance reviews of medical records for accuracy and completeness.
Business Office Customer Service Rep
Longview Regional Medical Center
Longview , TX
2011.01 - 2013.01
- Achieved outstanding results by prioritizing Customer Service and effectively handling diverse tasks
- Ensured accurate completion of accounts receivable and patient payment transactions on a daily basis
- Performed data entry of patient information into electronic health records system.
- Prepared correspondence and other documents as needed.
- Participated in team meetings and training sessions as required by the organization.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
Education
Medical Office Management-Technical Diploma -
Tyler Junior College
12.2017
High School Diploma -
North Desoto High School
05.1998
Skills
- Medical Billing
- Insurance Verification
- ICD-10 and CPT Coding Experience
- Managed Care Specialist
- Collections and Appeals
- Document Review
- Ability to interpret and read Explanation of Benefits
- MS Excel and Outlook Skills
- Attention to detail
- Claims Processing
- Medical Terminology
- Teamwork and Collaboration
- Self Motivation
- Time Management
Timeline
Patient Financial Navigator
Florida Cancer Specialists & Research Institute
2021.10 - Current
Insurance Eligibility and Authorization Coordinator
Bay Dermatology and Cosmetic Surgery
2019.06 - 2022.10
Customer Advocate/Benefit Value Advisor
HCSC Blue Cross and Blue Shield of Texas
2018.05 - 2019.05
Medical Office Receptionist and Billing Clerk
The Beverly Clinic
2014.04 - 2018.05
Demographics Representative/Medical Records
EmCare/MedAssociates
2013.01 - 2014.01
Business Office Customer Service Rep
Longview Regional Medical Center
2011.01 - 2013.01
Medical Office Management-Technical Diploma -
Tyler Junior College
High School Diploma -
North Desoto High School
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