Consawella Crowley
Shawnee,OK
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
20
20
years of professional experience
Work History
Insurance & Benefits Specialist
Citizen Potawatomi Nation Health Services
07.2023 - Current
- Explained benefits to plan participants in easy-to-understand terms in order to educate each on available options.
- Enter appropriate insurance information into RPMS & Computer Rx.
- Work closely with billing & accounts receivable staff to ensure insurance information is accurate & current.
- Review EOB's (Explanation of Benefits) for claims denied due to incorrect or terminated insurance coverage & research & correct insurance information.
- Call insurance companies or verify insurance eligibility for Medical, Dental, Behavioral Health, PT, Optometry, Pharmacy & any other applicable services online using the appropriate websites.
- Verify & enter all new insurance information into the RPMS patient registration software.
- Obtain Pre-Authorizations for upcoming procedures.
- Verify procedures are coded correctly for billing.
Patient Care Coordinator/Quality Assurance Analyst
United Health Group/OptumRx
01.2023 - 07.2023
- Answer 50-75 incoming calls per day from patients and/or health care providers and identify type of assistance needed.
- Make outbound calls to patients.
- Contact care providers on behalf of patient to assist with medications, appointment scheduling or connections with internal specialists.
- Document required information into computer systems.
- Set up delivery for patients of Oncology Specialty medication.
- Establish copay & collect from patient
- Customer service
- Manage prescriptions by sending electronic requests for new medications and refills.
- Connect patients with available community and charitable resources.
- Monitor and report on calls and customer interactions.
- Create reports that reflect support performance.
- Provide feedback to team leader and supervisors in call center.
- Ensure compliance with internal and regulatory guidelines and procedures.
- Mentored and coached team members on QA topics and strategies.
- Maintained confidentiality of patient data and condition to safeguard health information
Chiropractic Assistant
Family Wellness at Teravista
05.2022 - 01.2023
- Submit claims to insurance providers
- Appointment scheduling
- Marketing campaigns
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
- Promoted office efficiency, coordinating charts, completing insurance forms and helping patients with diverse needs.
- Contacted insurance carriers to determine patients' coverage and sent invoices for services rendered.
- Collected and documented patient medical information such as blood pressure and weight.
- Performed clerical duties, such as word processing, data entry, answering phones and filing.
- Implemented care and efficiency improvements to support and enhance office operations.
- Maintained detailed records of test results by entering data and patient information into computer.
Covid Relief Fund Program Supervisor
Citizen Potawatomi Nation
07.2021 - 05.2022
- Oversee the CARES program & staff
- Review rent & utility applications for accuracy before submitting to Audit for payment
- Date entry
- Link accounts for citizens so that they can apply for program assistance
- Customer service
- Train staff
- Communicate with different departments, tribal citizens & rent/utility companies
- Coached team members on productivity strategies, policy updates and performance improvement plans to accomplish challenging goals.
- Provided ongoing direction and leadership for program operations.
- Scheduled and supervised staff meetings to discuss new ideas and update participants on program details and milestones.
Medical Billing & Coding Specialist
REACT Ambulance Authority
01.2019 - 07.2021
- Data entry
- Customer service
- Speak to patients about billing
- Read & analyze patient reports for accuracy
- Determine correct codes to bill insurance
- Collections
- Analyze Explanation of Benefits
- File liens for motor vehicle accidents & contact attorneys
- Post payments
- Accounts receivables/payables
Executive Assistant
Sac & Fox Nation Housing Authority
06.2018 - 01.2019
- Provide assistance to Executive Director & Housing Authority staff in all areas of housing management including planning, organizing, directing & executing daily operations of the housing program administrations, operations & functions
- Perform general & specialized clerical duties & responsibilities
- Attend all meetings of the housing Board of Commissioners
- Prepare meeting agenda & minutes
- Organized and coordinated conferences and monthly meetings.
- Responded to emails and other correspondence to facilitate communication and enhance business processes.
- Processed travel expenses and reimbursements for executive team and senior management group.
- Transcribed minutes of meetings and executed meetings and events for company to support sales, business development and senior management teams.
- Handled logistics, catering, agendas and travel arrangements for meeting and event planning for board of directors, president and executive vice president.
- Distributed company-wide announcements, booked conference rooms and coordinated catering for annual staff development forum.
- Wrote reports, executive summaries and newsletters.
BSA Compliance Manager
Citizen Potawatomi Nation
06.2014 - 06.2018
- Implement & monitor policy & procedures
- Train & test all BSA compliant positions
- Audit all BSA & Federal Tax Reporting forms for accuracy & completion
- Continually obtain & review changes to Federal, State & Tribal regulations
- Effectively communicate current & revised policy & procedure changes to the Gaming Commission to ensure timely approval & acceptance
Education
Diploma -
Shawnee High School
ShawneeAssociates -
St. Gregory’s University
ShawneeSkills
- Leadership Skills
- Customer Service
- Insurance Practices
- Program Oversight
- Medical Terminology
- Healthcare Operations
- Medical Services Administration
- Patient Records Management
- Benefits Explanations
- 50 WPM Typing Speed
- Insurance Verification
- Scheduling
- Documentation
Timeline
Insurance & Benefits Specialist
Citizen Potawatomi Nation Health Services
07.2023 - Current
Patient Care Coordinator/Quality Assurance Analyst
United Health Group/OptumRx
01.2023 - 07.2023
Chiropractic Assistant
Family Wellness at Teravista
05.2022 - 01.2023
Covid Relief Fund Program Supervisor
Citizen Potawatomi Nation
07.2021 - 05.2022
Medical Billing & Coding Specialist
REACT Ambulance Authority
01.2019 - 07.2021
Executive Assistant
Sac & Fox Nation Housing Authority
06.2018 - 01.2019
BSA Compliance Manager
Citizen Potawatomi Nation
06.2014 - 06.2018
Diploma -
Shawnee High School
Associates -
St. Gregory’s University
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