Summary
Overview
Work History
Education
Skills
Timeline
Clorinda Bowser

Clorinda Bowser

Raleigh,North Carolina

Summary

  • Over ten years working in healthcare setting to include medical information release, inpatient and outpatient registration, professional and hospital claims processing, referrals, ancillary scheduling, medical staff liaison and conflict resolution related to entry level management.
  • Excellent customer service skills
  • Knowledge of medical terminology Scheduling Microsoft Office IDX Web, Microsoft, CCNC Informatics Center, HAC/AEMR, V1 Spa, V1 Front Desk, Trust Commerce, Siemens and various insurance carrier websites including MPV & BlueE
  • Knowledge of telephone etiquette Basic PC and data entry skills
  • Competent in communication skills, oral and written
  • Able to analyze data, perform multiple duties and work independently when applicable
  • Maintain kind, honest, respectful, direct and timely working relationships with patients, physicians, management and vendors.
  • Demonstrate ability to apply specific policies, rules and regulations to ensure compliance
  • Expertise in mastering new job skills quickly Innovative in developing new processes to increase productivity

Overview

21
21
years of professional experience

Work History

Cashier

Chapel Hill
Raleigh, NC
01.2021 - Current
  • Engage customers in friendly conversation while making eye contact and smiling
  • Accurately and efficiently scan customers' grocery items and complete monetary transactions
  • Properly bag items to ensure products arrive at their destination in the condition they left the store
  • Proactively offer additional assistance or services and thank the customer for shopping at Wegmans

Population Health Resource Associate – Team Lead

Population Health Management Office Duke WELL, Duke Health
Durham, NC
12.2016 - 08.2021
  • Create new workflows that will merge the following programs: traditional Duke WELL, NPCC Medicaid, MSSP – CCM and LATCH
  • Oversee a team of 8 persons who are responsible for referral intake
  • Contribute to the department’s design team building of a brand new structure of a new formed department
  • Provides regular oversight (including accompaniment into the field) of new hires and completes required performance adherence to program standards and implements improvement and development plans as needed
  • Utilize leadership principles to mobilize team to achieve positive outcomes
  • Conduct follow-up on outstanding matters to insure they are successfully resolved
  • Represents program interests at internal and external meetings
  • Collect and analyze key statistics (disease registries, biometrics, care management productivity, etc.) to ensure adherence to established care management protocols and benchmarks and investigates methods for improving service delivery
  • Complete chart reviews and facilitate peer review process among assigned staff members
  • Utilizes data to implement individual and program-level performance improvement activities (standardization of care, establishment of disease and population health metrics, consistency of reporting, information flow and management, job functions)
  • Assess training needs of new and existing staff, identifies and coordinates continuing education, in-services and staff development opportunities to ensure that skill-sets adhere to established core competencies.

Network Program Specialist

NPCC, Northern Piedmont Community Care, Duke Division of Community Health, Duke University
Durham, NC
12.2015 - 12.2016
  • Continue to perform duties of previous role of Clinic Service Representative/Referral Specialist with primary responsibility being the sole Referral Specialist at Duke Hospital for both adults and pediatric patients
  • Present care management services of NPCC to parent/guardians of pediatric patients by visiting patients’ hospital room at Duke Hospital
  • Supervise all Referral Specialists on staff
  • Facilitate trainings and workflow planning changes as needed
  • Assist management team in brainstorming best strategies for continued growth and change

Clinic Service Representative/Referral Specialist

Northern Piedmont Community Care, Duke Division of Community Health, Duke University
, Durham
06.2013 - 12.2015
  • Receive and screen telephone calls, and/or correspondence from patients, referring physicians or their staff, requesting appointment and provide informational assistance regarding Managed Care referrals, consultations, primary/specialty care services
  • Promote Duke Clinical Services through direct communications, cross selling services and providing literature as appropriate
  • Act as liaison and troubleshooter for individuals requesting clinical services, referrals, and/or other information; research inquiries as appropriate, follow through with caller and ensure resolution of information requests; obtain medical information from patients and referring physicians and communicate this information to physicians, nurses, and other providers
  • Assist patients with telephone registration procedure to include providing general information regarding managed care policies and appointment scheduling options
  • Coordinate and schedule patient appointments, consultations, and laboratory tests per information provided; ensure all tests and consults are scheduled in correct sequence, communicate to the patient special instructions, such as fasting related to clinic visit and/or laboratory test; enter pertinent data into the automated computer system
  • Obtain time availability from physicians and establish each physicians schedule in computer system, adjust and make changes in system
  • Assist with training co-workers and provide informational assistance to co-workers on an ongoing basis; assist management in identifying operational improvements, including technical systems changes and updates to computer system, to maximize efficiency and accuracy of services provided
  • Assist in compilation of data for regular and special reports.

Patient Account Associate - Integrative

Duke University Health Systems
Durham, NC
01.2012 - 06.2013
  • Influence the overall perspective of the facility by answering questions accurately and explain what the vision of the facility is, what services we provide and how we operate
  • Prepare for facility visits by reviewing upcoming programs, verifying applicable discounts and pending payments
  • Process classes, workshops and programs enrollment, arrivals and departures
  • Report classes, workshops and programs enrollment to designated staff weekly
  • Calculate discounts on services rendered
  • Check –in patients upon arrival by verifying and editing demographic data, accurately identifying insurance coverage, educating patients on HIPPA/Medicare forms required, explaining insurance benefits as needed and collect and post payments
  • Schedule physician, registered dietician, health psychology and therapeutic appointments as needed
  • Answer telephone and disseminate callers to the appropriate personnel
  • Audit encounter forms and complete daily nightly reports
  • Plan, schedule and facilitate facility tours
  • Review patient/client charges to ensure accuracy and answer questions concerning billing processes and charges
  • Recommend efficient means of clinic service activities that will foster optimal patient care.

Financial Care Counselor

Duke University Health Systems
Durham, NC
01.2004 - 01.2012
  • Oversaw daily clinical operations in the absence of immediate management
  • Analyzed insurance coverage and benefits prior to scheduled appointments to guarantee timely reimbursement
  • Accurately processed patient accounts through front end registration by add/edit insurance to ensure all requirements were met
  • Obtained prior authorization for procedures scheduled
  • Reconciled daily clinic collections
  • Resolved patient billing complaints by explaining PRMO revenue process and insurance carriers’ explanation of benefits’
  • Examined and explained patients’ insurance policies
  • Updated billing system with patient’s current insurance and documented financial counseling
  • Made referrals to specialty offices and notified patients within seven days of physician’s request
  • Informed physicians of any patient financial hardships
  • Arranged payment options

Patient Service Associate

Duke University Health Systems
Durham, NC
01.2002 - 04.2004
  • Greeted patients with a smile
  • Identified corrected patient and updated accordingly
  • Entered lab and/or ancillary orders
  • Distributed insurance information to financial care counselors as needed
  • Filed encounter forms for retrieval if needed
  • Managed all appropriate IDX alerts
  • Scheduled ancillary appointments and notified patient within three days of physician’s request
  • Reconciled daily accounts receivables

Education

Diploma -

Northwest Halifax High School
06.1992

Skills

  • Stocking and Replenishing
  • POS Systems
  • Point of Sale Knowledge
  • Liquor Law Compliance

Timeline

Cashier - Chapel Hill
01.2021 - Current
Population Health Resource Associate – Team Lead - Population Health Management Office Duke WELL, Duke Health
12.2016 - 08.2021
Network Program Specialist - NPCC, Northern Piedmont Community Care, Duke Division of Community Health, Duke University
12.2015 - 12.2016
Clinic Service Representative/Referral Specialist - Northern Piedmont Community Care, Duke Division of Community Health, Duke University
06.2013 - 12.2015
Patient Account Associate - Integrative - Duke University Health Systems
01.2012 - 06.2013
Financial Care Counselor - Duke University Health Systems
01.2004 - 01.2012
Patient Service Associate - Duke University Health Systems
01.2002 - 04.2004
Northwest Halifax High School - Diploma,

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Clorinda Bowser