Danyale K. Champion
Rockford,IL
Summary
Compassionate Patient Service Representative with a strong background in patient access roles. Experienced in managing patient registration, insurance verification, and appointment scheduling. Proven ability to improve patient satisfaction and streamline processes. Ready to contribute to team success with a strong work ethic and adaptability.
Overview
18
18
years of professional experience
Work History
Patient Access Associate
OSF Saint Anthony Medical Center
Rockford, Illinois
06.2023 - Current
- Managed patient registration and verification process efficiently.
- Assisted patients with insurance inquiries and eligibility checks.
- Scheduled appointments and coordinated patient flow within the facility.
- Facilitated billing transactions to ensure timely payment collection.
Senior Claims Analyst
Lucent Health/Cypress Benefits Administrators
Beloit, Wisconsin
07.2022 - 05.2023
- Analyzed claims to ensure compliance with industry regulations and company policies.
- Reviewed documentation for accuracy and completeness, ensuring timely claim submissions.
- Collaborated with healthcare providers to resolve claim disputes and inquiries, enhancing resolution processes.
- Managed claims processing workflow, streamlining operations to reduce delays.
ERISA Appeals Specialist (Remote)
Agros Health
Dallas, Texas
12.2021 - 04.2022
- Reviewed and processed appeals for medical claims and services.
- Communicated with healthcare providers to gather necessary documentation.
- Researched policies and regulations to ensure compliance in appeal decisions.
- Collaborated with team members to streamline appeal workflows and procedures.
- Analyzed case files to identify discrepancies and required follow-up actions.
Medical Claims Examiner
First Source
Rockford, Illinois
04.2020 - 12.2021
- Reviewed medical claims for accuracy and compliance with company policies.
- Analyzed claim documentation to identify discrepancies and potential issues.
- Processed claims using electronic systems to ensure timely handling.
- Maintained detailed records of claims and correspondence for auditing purposes.
Pre-Certification Specialist
Javon Bea Hospital
Rockford, Illinois
10.2018 - 03.2020
- Reviewed insurance authorizations to ensure compliance with hospital policies.
- Coordinated with healthcare providers to gather and submit necessary precertification documents, ensuring timely processing.
- Maintained accurate records of precertification requests and approvals in the system.
- Collaborated with insurance companies to resolve authorization issues, enhancing approval rates and reducing delays.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Compiled and submitted precertification requests for payer review, adhering to established timelines to ensure prompt approvals.
Medical Claims Examiner
First Source
Rockford, Illinois
06.2013 - 09.2018
- Reviewed medical claims for accuracy and compliance with company policies.
- Analyzed claim documentation to identify discrepancies and potential issues.
- Processed claims using electronic systems to ensure timely handling.
- Maintained detailed records of claims and correspondence for auditing purposes.
IHC Health Solutions
Customer Service Supervisor
Rockford, Illinois
06.2008 - 06.2013
- Resolved customer issues with knowledgeable and friendly service, resulting in high customer satisfaction.
- Assisted with customer requests and answered questions to improve satisfaction.
- Assessed customer needs quickly during interactions.
- Proposed innovative ideas and solutions that improved team performance and outcomes.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Executed day-to-day duties with precision and efficiency.
Education
High School Diploma -
Thomas Jefferson High School
Rockford, IL06-1993
Skills
- Patient intake
- Appointment scheduling
- Eligibility confirmation
- Insurance verification
- Claims processing
- Claim analysis
- Documentation accuracy
- Compliance adherence
- Patient check-in
- Registration and admissions
- Scheduling diagnostic procedures
- Follow-up coordination
- Healthcare software expertise
- Data entry proficiency
- Payment processing
- Healthcare systems navigation
- Medical terminology
- HIPAA compliance
- Privacy regulations knowledge
- Attention to detail
- Time management
- Effective communication
- Verbal and written communication
- Phone and email communication
- Customer service
- Client relationship management
- Relationship building
- Customer follow-up
- Multi-channel outreach
- Problem solving
- Team collaboration
- Problem-solving
- Team leadership
- Workflow optimization
- Policy understanding
- Information collection
- Strong empathy
- Flexible schedule
- Money handling
- Data entry
- Admitting coordination
- Patient education
- Appointment reminders
- Problem-solving
- Team leadership
Timeline
Patient Access Associate
OSF Saint Anthony Medical Center
06.2023 - Current
Senior Claims Analyst
Lucent Health/Cypress Benefits Administrators
07.2022 - 05.2023
ERISA Appeals Specialist (Remote)
Agros Health
12.2021 - 04.2022
Medical Claims Examiner
First Source
04.2020 - 12.2021
Pre-Certification Specialist
Javon Bea Hospital
10.2018 - 03.2020
Medical Claims Examiner
First Source
06.2013 - 09.2018
IHC Health Solutions
Customer Service Supervisor
06.2008 - 06.2013
High School Diploma -
Thomas Jefferson High School