CRYSTAL RICKMAN
Dearborn Heights,Michigan
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
7
7
years of professional experience
Work History
Patient Care Coordinator
Sedgwick
Salt Lake City, UT
05.2023 - Current
- Kept track of ongoing care and intervened when issues arose
- Act as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
- Handle multiple special billing projects as requested.
- Review and verified documentation supports proper coding regarding diagnosis, procedures, and treatments.
Contract Claims Associate-Sedgwick
Cynet Health
10.2022 - 05.2023
- Handled high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines.
- Processes first party property claims based on basis coverage as defined by client-specific program.
- Adjudicated proper settlement or denials up to designated authority level.
- Assist leaders with payment investigation process in timely manner.
- Followed up with customers on unresolved issues.
Medical Biller
Advantage Medical Billing
07.2021 - 10.2022
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility monthly.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Identifies diagnostics and procedure information on 100 claims daily.
- Posted 100% payments and collections on regular basis.
Customer Service Representative
Meridian/Centene
07.2019 - 07.2021
- Handled members complaints, provided appropriate solutions and alternatives in regards to benefits, providers, claim details and handbook.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
- Exhibited high energy and professionalism when dealing with clients and staff
- Met customer call guidelines for service levels, handle time and productivity of 98% weekly.
Medical Biller
Therapeutic LLC
10.2020 - 06.2021
- Processed medical claims for counseling sessions, medical evaluations, dosage and case management
- Assisted with communication within clinical department (Physicians, Nurses, Counselors, Case Managers, and Billers)
- Assisted leadership with marketing and billing project to met 100% monthly quota.
- Identified all discrepancies, quality of care, and major billing issues.
Wound Care Secretary
Garden City Hospital
07.2018 - 02.2020
- Maintained clean and safe environment to promote patient safety and comfort.
- Responded to patient emergencies with immediate care and notified clinicians to provide comprehensive assistance.
- Organized and replenished unit supplies to maintain team readiness for expected demands.
- Kept a monthly report on insurance verification; collect copays, assisted patient with insurance benefit details and scheduled weekly accordingly.
Patient Representative
Beaumont Hospital
09.2017 - 07.2018
- Registered patients in accuracy and timely manner and obtained insurance and demographic information.
- Answered patient assistance calls, assessed needs, and offered qualified support
- Resolved customer complaints using established follow-up procedures
- Organized patient records and database to facilitate information storage and retrieval
Data Entry Operator
Datamatics
01.2017 - 09.2017
- Completed data entry tasks with accuracy and efficiency.
- Verified data files prior to entry to maintain high data accuracy.
- Corrected data entry errors to prevent duplication or data degradation.
- Scanned documents and saved in database to keep records of essential organizational information.
Education
Bachelor of Science - Healthcare Management
Independence University
Salt Lake City, UT12.2017
Skills
- Healthcare operations
- Goal Setting
- Multitasking ability
- Organizational skills
- Claims Processing
Timeline
Patient Care Coordinator
Sedgwick
05.2023 - Current
Contract Claims Associate-Sedgwick
Cynet Health
10.2022 - 05.2023
Medical Biller
Advantage Medical Billing
07.2021 - 10.2022
Medical Biller
Therapeutic LLC
10.2020 - 06.2021
Customer Service Representative
Meridian/Centene
07.2019 - 07.2021
Wound Care Secretary
Garden City Hospital
07.2018 - 02.2020
Patient Representative
Beaumont Hospital
09.2017 - 07.2018
Data Entry Operator
Datamatics
01.2017 - 09.2017
Bachelor of Science - Healthcare Management
Independence University
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