Diamond Gross

• Enhanced patient satisfaction by managing appointment scheduling, billing, and insurance verification processes.
• Assisted patients with payment plans, ensuring timely payments and reducing outstanding balances.
• Served as a liaison between patients and healthcare providers, ensuring accurate communication of financial responsibilities.
• Provided exceptional administrative support during high-pressure situations, maintaining a calm and professional demeanor.
• Streamlined insurance verification tasks, minimizing billing discrepancies and patient financial concerns.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
• Collaborated with insurance companies to verify coverage details and obtain authorizations for service provision as required.
• Participated in ongoing training sessions to stay updated on industry trends, products, and best practices for exceptional member support.

• Welcome everyone to the office and be the first contact for all members and visitors
• Works closely with Providers, Pharmacist, and Counselors.
• Responsible for managing both the Newport News Virginia Groups office, as well as the Hayes Virginia Groups office. Maintaining overall office appearance
• Travel between offices
• Responsible for coordinating member medication counts, completing health/safety drills, monitoring PDMP for state compliance, and adhering to office compliance standards
• Complete monthly drills
• Manage PEX card funds, submit monthly expenses.
• Manage & collect co-payments
• Update spreadsheets daily with new patients, drug screen results, and demographics for both offices.
• Attend weekly meetings with staff
• Requires strong attention to details and the ability to manage a large workload
• Written electronically prescriptions/prescription management.
• Provided support and care navigation tools for patients as needed.
• Weekly outreach
• Send appointment reminders, Check in/out patients, reschedule appointments as needed.
• Oversaw office inventory by ordering and stocking and shipment receiving.
• Observe patients complete weekly urine drug screens/document results
• Ship supplies via FedEx to patients as needed.
• Managed office operations while scheduling appointments for counselors and providers.
• Complete monthly deadlines in a timely matter.
• Demonstrated respect, friendliness and willingness to help wherever needed with other offices.
• Coordinate with medical providers on scheduling and member needs.
• Enforced compliance with government regulations and company policies.
• Attend local community events
• Complete pre-auths as needed

• Successfully scheduled patient appointments and placed reminder calls to deliver exceptional customer experience.
• Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
• Organized patient files and streamlined operations to improve efficiency.
• Verified insurance coverage to prepare for upcoming patient appointments.
• Communicated with patients regarding payments on outstanding accounts.
• Facilitated organized record retrieval and access by maintaining filing system for both in-house and discharged residents.
• Coordinated front office duties, including customer service, patient scheduling and billing.
• Create Resident trust fund accounts,
• Responsible for submitting all TPL , DMAS80, and DMAS225
• Scan and process reimbursement checks and petty cash checks.
• Key all resident trust fund withdraw forms.
• Oversaw office inventory activities, including ordering and requisitions, stocking and shipment receiving.
• Verified and tracked all project deadlines to facilitate smooth workflow and satisfied clients.
• Performed accounts receivable collections for past due accounts by conducting collection calls.
• Reviewed patient records, identified medical codes and created invoices for billing purposes.
• Assisted patients by determining financial assistance available and setting up payment plans.
• Efficiently collected payments and communicated with patients.
• Posted payments and collections on regular basis.
• Liaised between patients, insurance companies and billing office.

•Scanned and filed medical records in alphabetical order to maintain
organized and up-to-date filing system.
•Posted payments and collections on regular basis.
• Maintained current accounts through aged revenue reporting.
Submitted electronic and paper claims to insurance companies
including Medicare and Medicaid to collect medical payments.
•Reviewed outpatient records and interpreted documentation to
identify all diagnoses and procedures.
• Scheduled patients in Medical Manager System.
Complied with all HIPAA Privacy and Security Regulations to protect
patients' medical records and information.
• Filed and updated patient information and medical records.
• Transferred balances to correct payers.
Oversaw all billing for Medicaid PCA, waiver and skilled claims,
commercial insurance and private pay clients.
• Completed client requests and advised supervisors of special needs.
Prepared billing statements for patients and verified correct diagnostic
coding.
•Communicated with insurance providers to resolve any denied claims
and resubmit.
• Liaised between patients, insurance companies and billing office.
Verified signatures and checked medical charts for accuracy and
completion.
• Managed billing calendar and scheduled claims for payments.
• Reviewed outgoing bills for eligibility and accurateness.
•Offered payroll-related subject matter expertise to management and
employees to resolve payroll discrepancies.

• Assisted patients in filling out check-in and payment paperwork.
•Workers Compensation, Drug Screening, Physicals, PPD placement
registration.
• Balanced deposits and credit card payments each day.
• Took copayments and compiled daily financial records.
• Maintained excellent attendance record, consistently arriving to work
on time.
• Promptly answered multi-line phone system and greeted callers
enthusiastically.
• Obtained payments from patients and scanned identification and
insurance cards.
• Checked patient data including insurance, demographic and health
history to keep information current.
• Managed office logistics by scheduling appointments, maintaining files
and collecting payments.
• Carefully transcribed phone messages and relayed to appropriate
personnel within 5 minutes of each call.
• Adhered to strict HIPAA guidelines at all times to protect patient
privacy.
• Documented patient medical information, case histories and insurance
details to facilitate smooth appointments and payment processing.
• Organized paperwork such as charts and reports for office and patient
needs.

Explained plans for treatment and payment options

• Explained plans for treatment and payment options.
• Assisted patients in filling out check-in and payment paperwork.
• Balanced deposits and credit card payments each day.
• Took copayments and compiled daily financial records.
• Explain policies, procedures, or services to patients using medical or
administrative knowledge.
• Registered new patients for either Speech, Occupational, or Physical
therapy.
• Requested for any authorization needed.
• Enter all patient data into electronic medical record within a timely
fashion from phone contact prior to patient meeting with Therapist.
• Maintain patient data up-to-date and verify patient information at
every visit.
• Verify patient's insurance coverage and collect co-payments.
• Greet and direct patients to examination rooms
• Review patient accounts, identify delinquent accounts and collect due
amounts.
• Assist patients in filling patient consent forms and payment contract
forms.
• Respond to patient queries and concerns in a professional manner.
Obtain patient address, contact details, insurance information and
medical history
• Filing, Scanning, Faxing, and Shredding
• Documenting all safe transactions
• Used Software to schedule appointments

TRICARE
• Analyze claims to determine if eligibility requirements and claim filing
requirements are met and make determinations Read and assessed
medical documents.
• Used administrative guidelines as resource or to answer questions
when processing medical claims.
• Answer billing inquiries for patients, providers, and staff Proficient with
Medical terminology knowledge of CPT and ICD-10 physician procedural
coding.
• Located errors and promptly refiled rejected claims.
• Process all claim types by determining corrective action to be taken on
various types of errors pending by the system and resolving interactive
edits.
• Translate, research, and verify claim information to determine if all
requirements have been met.
• Review submitted claim information and select correct procedure code
and diagnosis code using ICD-9, ICD-10, CPT and HCPCS manual.
• UB-04 Claims
• Maintained knowledge of benefits claim processing, claims principles,
medical terminology and procedures and HIPAA regulations.
• Performed billing and coding procedures for ambulance, emergency
room, impatient and outpatient services.
• Communicated with patients for unpaid claims for HMO, PPO and
private accounts and delivered friendly follow-up calls for proper
payments to contracts.
• Managed large volume of medical claims on daily basis.
• Maintained confidentiality of patient finances, records and health
statuses