Dessaray Reid
Milwaukee,Wisconsin
Summary
Highly dedicated and reliable Insurance Verification Specialist with excellent insurance document organization and interpretation skills. Wide experience with all public and private health insurance practices and policies. Adept at coordinating with insurance company staff at all levels as well as working independently
Overview
16
16
years of professional experience
Work History
Patient Care Coordinator
Optum
10.2021 - Current
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Assisted patients with completing necessary paperwork and forms to provide healthcare facilities with essential information to bill for services.
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
Insurance Coordination/Authorization
Advent
09.2017 - 10.2021
- Begin authorization/certifications for all surgeries as required by the patient’s insurance carrier, within two days after orders are entered
- Obtain authorizations for all testing and studies as required by the patient’s insurance carrier
- Counsels patients regarding benefit information, out of pocket cost, and deposit requirements and due dates
- Coordinates scheduling and financial aspects of treatment procedures
- Assist patients with information necessary to pay all medical charges, discussing in house financing availability
- Receive all needed medical records and history from patients
- Obtain patients’ test results and assess information from the report to determine if a patient is ready for surgery
- File, collect, and organize pre- and post-operational data for reference
- Obtain authorizations for six Wisconsin and Illinois locations for two Medical Doctors.
Insurance Verification/Prior authorization specialist
Froedtert & The Medical College of WI
12.2016 - 09.2017
- Determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care
- Provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is Documenting the appropriate information in the patient's record
- Verifies eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to delivery of inpatient, outpatient, and ancillary services
- This individual Determines which patient services have third party payer authorization requirements and collaborates with the appropriate clinical partners, case managers, financial counselors, payers, and others to make sure the necessary authorization is obtained
- Provides detailed and timely communication in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record.
Insurance Authorization Representative/clinical office assistant
Aurora Health Care
08.2014 - 12.2016
- Enter patient data by alpha & numeric entries
- Maintain accurate records by using procedures & policies accurately
- Ensure Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third party payer requirements/on-line eligibility systems
- Ensures all services have prior authorizations and updates patients on their preauthorization status
- Coordinates peer to peer review if required by insurance
- Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients
- Follows up with physician offices, financial counselors, patients and third-party payers to complete the pre-certification process.
Clinical office Assistant
Aurora Health Care
- Answers and screens telephone calls, triages clinical calls and resolves problems
- Schedules patients and enters information into the computer system
- Coordinates patient appointments with other areas or physician offices as needed
- Greet patients and visitors in a prompt, courteous, and helpful manner, collects insurance co-payments, and responds to routine requests for information
- Generate basic reports, modifies/updates existing reports, and distributes reports as needed.
Document Processor (Clerk III)
HP Enterprise Milwaukee
10.2011 - 08.2014
- Scan and process numerous documents
- Open and distribute mail throughout various departments
- Use kofax, a computer program, to enter and obtain data
- Multi-task and achieve department goals by the end of each work day.
Collector
Wells Fargo Home Mortgage
10.2008 - 10.2011
- Assisting mortgagors in bringing their loans current by setting up payment plans to cure their delinquent amount
- Processing loan payments.
Education
High School Diploma -
James Madison Academic Campus
Milwaukee, WI06.2002
Skills
- EPIC Health care system
- MOD MED Health System
- Customer Service
- Computer knowledge (Microsoft Excel, Access, Word, and Power Point)
- Exceptional research and writing skills
- Professional Ethics Training (Through Workshops)
- Leadership Training Experience (Through Workshops)
- Insurance verification / authorizations
- Billing problems resolution
- Delinquent accounts monitoring
- Customer service
- Denied claims identification
- Service activity monitoring
- Electronic workflow completion
- Front desk assistance
Cover Letter
Dear Prospective Employer:
Please accept this letter and my accompanying resume as my expressed interest in working with you.
I’m detail-oriented and able to identify and solve problems effectively. I especially enjoy challenges, diversity in daily tasks, and working with people. My personal characteristics include a high level of dedication to my work and strong values of integrity and honesty.
I pride myself in being dedicated to hard work and the ability to achieve every goal that I have set. I’m a determined and adaptive individual. I strongly believe that I’m ready to meet and exceed the challenges that are presented to me.
Thank you for taking the time to review my resume. If you have any further questions, feel free to contact me at (414) 397-6962.
Sincerely,
Dessaray Reid
Timeline
Patient Care Coordinator
Optum
10.2021 - Current
Insurance Coordination/Authorization
Advent
09.2017 - 10.2021
Insurance Verification/Prior authorization specialist
Froedtert & The Medical College of WI
12.2016 - 09.2017
Insurance Authorization Representative/clinical office assistant
Aurora Health Care
08.2014 - 12.2016
Document Processor (Clerk III)
HP Enterprise Milwaukee
10.2011 - 08.2014
Collector
Wells Fargo Home Mortgage
10.2008 - 10.2011
Clinical office Assistant
Aurora Health Care
High School Diploma -
James Madison Academic Campus