Crystal Moran
New Albany,IN
Summary
Dedicated administrative professional well-versed in communication and team building. Knowledgeable in medical terminology and scheduling. Ready to bring 20 years of relevant work experience to your team. Dependable serving diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Skilled at analyzing case files and databases to speed up inquiry response times and guide information through appropriate personnel channels. Maintains highest standards of ethics, professionalism and regulatory compliance to ease common stressors and de-escalate potential conflicts. Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
26
26
years of professional experience
Work History
Patient Access Representative
University of Louisville Medical Center
08.2023 - Current
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
- Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
Total Care Family LLC
Total Care Family LLC
11.2022 - 06.2024
- Responsible for administrative as well as clinical tasks
- Review and verify accuracy of patient demographic and insurance information
- Enter and update patient information in the billing system
- Assign appropriate medical codes to diagnoses and procedures based on documentation provided by healthcare professionals
- Prepare and submit electronic and paper claims to insurance companies
- Monitor and track claim status to ensure timely payment
- Follow up with insurance companies and patients regarding unpaid or denied claims
- Investigate and resolve billing discrepancies and claim rejections
- Respond to inquiries from patients, insurance companies, and healthcare providers regarding billing issues
- Stay up-to-date with changes in medical billing and coding regulations and guidelines
- Maintain patient confidentiality and adhere to HIPAA regulations.
UPS
UPS
07.2021 - 11.2022
- Preparation of customs entries and forwarding freight to designated locations
- This may involve interface with international and domestic carriers, overseas offices, and importers
- Prepare Customs entries and follow-up with the clearance process on all entries prepared
- Communicate documentation discrepancies to client and supervisor
- Coordinate freight delivery to designated locations
- Resolve finance and accounting reconciliation exchange issues
- Responsible for filing entries to customs via GBS-CM in a timely and accurate manner
- Administrative responsibilities include preparation of reports/presentations and analysis using various software packages and databases
- Document review and assessment of accuracy, verifying country of origin/export, IOR, terms of sale and value to ensure that compliance and federal regulation requirements are achieved
- Daily follow up on documentation discrepancy issues which requires the ability to troubleshoot and communicate effectively, both verbally and in writing with customers and foreign origins.
Accounts Receivable Representative
Gastroenterology Health Partners
11.2018 - 06.2021
- Demonstrates commitment to the quality philosophy and values by maintaining established policies and procedures, organizational objectives, process improvement, and safety standards
- Demonstrate the philosophy of patients first in all interpersonal relations
- Investigates, analyzes and resolves problematic and delinquent insurance claims
- Reviews insurance receivable for divisions and notifies Manager of potential problems
- Utilizes clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure code authorizations to substantiate corrected claims submissions, written appeals and coding reviews
- Comprehends Electronic Data Interchange (EDI) functionality and the general progression of data in the PM system and EDI systems (Clearinghouse
- Reports deviations from divisional policies and procedures
- Knowledge of medical terminology, CPT, ICD-10-CM, HCPC codes, CCI edits and HIPAA regulations
- Interacts effectively with internal and external customers via telephone or email
- Drafts professionally written appeal letters to overturn denied claims
- Responds to carrier requests for medical documentation and other source documents.
EMR Technician
Norton Healthcare
02.2017 - 11.2018
- Scanning and indexing medical records
- Traveling to Norton Facilities to pick up medical records to bring back to office for scanning in EPIC system
- Answering incoming calls regarding medical records.
- Participated in regular team meetings to discuss system updates, data entry best practices, and emerging trends in electronic medical recordkeeping.
- Enhanced healthcare provider access to crucial information by organizing and maintaining electronic medical records.
- Coordinated with clinical staff to clarify any discrepancies or missing information in medical records, resulting in more accurate patient care documentation.
- Contributed to HIPAA compliance efforts by ensuring secure storage, transmission, and handling of sensitive patient information within the EMR system.
Pre Medical Recovery Specialist
Equian Trover Solutions
04.2016 - 02.2017
- Review, type and order electronic history on all assigned files
- Responding to incoming phone calls related to assigned files
- Negotiate files with attorneys, third parties adjusters and or client's
- Respond to written correspondence on assigned files
- Update file liens
- Perform file investigation as required.
Front Office Clerk/Clinical Data Abstractor/Nursing Assistant
Baptist Healthcare
01.2012 - 05.2015
- Collecting co pay
- Registration of patients
- Scheduling appointments for patients for out patient procedures
- Medical records
- Traveling to different Baptist Healthcare Systems to prepare for new EMR system
- Office coordinator managed front office
- Billing and inputting payroll in system
- Ordering Medical supplies as needed.
- Improved overall organization of the front office by implementing efficient filing systems for important documents such as registration forms and invoices.
- Maintained confidentiality of guest information by adhering to strict data protection policies and procedures.
- Directed phone inquiries, answered customer questions, and scheduled appointments.
- Maintained a professional and welcoming atmosphere, resulting in repeat business from satisfied customers.
- Processed payments and informed individuals of further financial responsibility to facilitate timely payments.
- Handled financial transactions accurately while adhering to company policies and procedures.
Jewish Hospital
Jewish Hospital
10.2011 - 01.2012
- Responsible for greeting and registering patients, as well as verifying all patient information and insurance details
- Collect co pays, answer calls and page employees as needed.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Processed policy updates and changes accurately, ensuring client needs were met in a timely manner.
- Completed customer applications and updated records to reflect current information.
Provider Maintenance Specialist
Preferred Health Plan
10.1998 - 10.2011
- Responsible for provider's profiles and contracts/fee schedules
- Making sure data bases remain current with the correct information for participating and non-participating providers.
- Maintained strong relationships with providers, fostering trust and open communication channels for issue resolution.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Enhanced patient satisfaction by efficiently scheduling surgeries and pre-operative appointments.
- Expedited registration process for new patients by gathering necessary information prior to their arrival at the hospital or clinic setting.
- Supported successful surgical outcomes by ensuring accurate documentation of patient medical histories, insurance information, and surgical consents.
Education
Phlebotomy -
Spencerian College
01.2003
Skills
- Experience of more than 20 years and in depth knowledge of medical billing and insurance and procedures Comprehensive knowledge of medical billing and insurance claims and account receivable Exceptional communication skills both written and verbal Excellent knowledge of medical terminology Scanning documents into Electronic Health Record/EPIC and ALLSCRIPTS Patient scheduling, collecting of co pays and registration of patients Credentialing of providers Maintaining data base for participating and non-participating providers Dean Vaughn Medical Terminology 350 Office Administration Medical Records/Health Information Bookkeeping Patient Scheduling
- Patient Registration
- HIPAA Compliance
- Insurance Verification
- Customer Service
- Appointment Scheduling
- Medical Terminology
- Healthcare systems navigation
- EMR
- EMR Updating
- Scheduling Diagnostic Procedures
Timeline
Patient Access Representative
University of Louisville Medical Center
08.2023 - Current
Total Care Family LLC
Total Care Family LLC
11.2022 - 06.2024
UPS
UPS
07.2021 - 11.2022
Accounts Receivable Representative
Gastroenterology Health Partners
11.2018 - 06.2021
EMR Technician
Norton Healthcare
02.2017 - 11.2018
Pre Medical Recovery Specialist
Equian Trover Solutions
04.2016 - 02.2017
Front Office Clerk/Clinical Data Abstractor/Nursing Assistant
Baptist Healthcare
01.2012 - 05.2015
Jewish Hospital
Jewish Hospital
10.2011 - 01.2012
Provider Maintenance Specialist
Preferred Health Plan
10.1998 - 10.2011
Phlebotomy -
Spencerian College
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