Decell Smith
Houston,TX
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Eligibility Coordinator
Meduit
09.2021 - Current
- Provided liaison services between the Georgia Medicaid program, Veterans Administration, Social Security.
- Inter interview and investigated applicants and recipient to determine eligibility where are you state program, Veterans administration and Social Security.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Scheduled appointments with applicants to gather information such as proof of income, bank statements, proof of address, identification, passport, permanent residence card, etc.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals.
- Trained staff on current eligibility requirements and policies.
- Engaged wider departments in accurate, timely paperwork completion.
- Assisted clients with completion of applications and paperwork.
Insurance Team Leader
Woolfson Eye Institute
09.2017 - 07.2021
- Verified eligibility and compliance with authorization requirements for service providers.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Tracked referral submission during facilitation of prior authorization issuance.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Applied effective time management techniques to meet tight deadlines.
- Developed and maintained courteous and effective working relationships.
- Participated in team projects, demonstrating an ability to work collaboratively and effectively.
- Identified issues, analyzed information and provided solutions to problems.
- Exercised leadership capabilities by successfully motivating and inspiring others.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Patient Financial Counselor
Medix Staffing
12.2015 - 09.2017
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Greeted and assisted patients with check-in procedures.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Organized patient records and database to facilitate information storage and retrieval.
- Provided excellent customer service to patients and medical staff.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Verified patient insurance eligibility and entered patient information into system.
- Trained new staff on filing, phone etiquette and other office duties.
Patient Access Representative
Methodist Hospital
10.2010 - 08.2013
- Used multiple EMR system, complete registration process, obtain patients Identification and Insurance card.
- Educated patients on importance of preventive health care and insurance coverage.
- Schedule patient’s appointments, communicate with providers, and clinical staff, registration, update demographics and obtain signatures on consent forms.
- Check insurance eligibility and benefit details.
- Resolved patient billing issues in line with established guidelines.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Delivered support to medical staff in completion of patient paperwork.
- Adhere to HIPPA regulations and PHI.
Education
Bachelor Of Healthcare Administration - Healthcare
Purdue University
West Lafayette, INSkills
- Policy Knowledge
- Government Regulations
- Effective communication skills
- Appointment Scheduling
- Quality Assurance
- HIPAA Compliance
- Customer Service
- Training Coordination
- Problem-Solving
- Multitasking and Organization
- Registration management
- Medicaid knowledge
- Application processing
- Eligibility Determination
- Policy Interpretation
- Insurance Coverage Verification
Certification
BLS
Leadership
Epic Training completion
Timeline
Eligibility Coordinator
Meduit
09.2021 - Current
Insurance Team Leader
Woolfson Eye Institute
09.2017 - 07.2021
Patient Financial Counselor
Medix Staffing
12.2015 - 09.2017
Patient Access Representative
Methodist Hospital
10.2010 - 08.2013
Bachelor Of Healthcare Administration - Healthcare
Purdue University