Crystal Pointe
Burlington,North Carolina
Summary
With over a decade of extensive experience in the medical industry, specializing in patient scheduling, pre-certification, claims and benefits. With a strong and lengthy background in remote support, Crystal Pointe exhibits a commitment to excellence by providing the best patient experience with interacting with patients.
Dedicated front office professional with successful experience in fast-paced office settings. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision and self driven.
Overview
13
13
years of professional experience
Work History
Office Specialist
AHWFB-High Point Physical Therapy
01.2024 - Current
- Optimized scheduling and appointment coordination, ensuring smooth daily operations for all team members.
- Demonstrated adaptability by quickly learning new software programs and office tools as required, continuously improving skill set.
- Handled incoming calls professionally, routing callers appropriately or taking detailed messages when necessary.
- Greeted incoming patients and visitors professionally and provided friendly, knowledgeable assistance.
- Insurance verification and benefits
- Patient scheduling
- Obtain authorization
Insurance Verification Specialist
Novant Health
08.2018 - 10.2024
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Patient scheduling
- Workers Comp claim management
Claims Representative II
United Healthcare Group
06.2012 - 08.2018
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Provided benefit and coverage information with members
Education
No Degree - Phlebotomy And Medical Terminology Program
Heath Professionals Institute
Fedeal Way, WAr04-2008
Associate of Applied Science - Health Administration
Rose State College
Oklahoma City, OK05-2004
High School Diploma -
Millwood High School
Oklahoma City, OK05-2002
Skills
- Strong knowledge of commerical, community and Medicare health plans
- Scheduling
- Attention to detail
- Insurance coverage verification
- HIPAA compliance
- Patient confidentiality
- Over 12 years experience in healthcare field working in office setting, call center and remote setting
- Held 98% quality score for consecutive 5 years
- Finley honed customer service skills
- Over 6 years experience with Epic
- Patient registration
Timeline
Office Specialist
AHWFB-High Point Physical Therapy
01.2024 - Current
Insurance Verification Specialist
Novant Health
08.2018 - 10.2024
Claims Representative II
United Healthcare Group
06.2012 - 08.2018
No Degree - Phlebotomy And Medical Terminology Program
Heath Professionals Institute
Associate of Applied Science - Health Administration
Rose State College
High School Diploma -
Millwood High School
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