Summary
Overview
Work History
Education
Skills
Timeline
Generic

Diedre GastonSmith

Summary

Dedicated administrative professional well-versed in communication and team building. Knowledgeable in medical terminology and scheduling. Ready to bring 22 years of relevant work experience to your team.

Overview

15
15
years of professional experience

Work History

Care Access Coordinator

Optum
12.2024 - Current

Answer all incoming calls and assist patients with pre-registration for upcoming surgeries and procedures.

Assist incoming callers with scheduling appointments for diagnostic and nuclear medicine testing, and schedule neurology office consult and follow up appointments.

  • Improved patient access by streamlining registration processes and reducing wait times.
  • Served as a liaison between patients and healthcare providers, ensuring clear communication of expectations and needs throughout the treatment process.

Insurance Verification Coordinator

Riverside Health Services
09.2023 - 06.2024
  • Verify patient's insurance and eligibility via RTE, various insurance portals, and home plan customer service representatives.
  • Use provider portals to obtain authorizations.
  • Answering and initiating phone calls to/from insurance companies.
  • Utilize Epic systems.
  • Authorization management and follow up.
  • Data base updates.
  • Maintain patient confidentiality and security of patient information.

Clinical Insurance Reviewer

Physician Reliance Network/McKesson Healthcare Company/Maryland Oncology Hematology
07.2022 - 09.2023
  • Insurance verification and eligibility.
  • Obtain insurance pre authorizations for chemotherapy and radiation patients.
  • Answering and initiating phone calls from insurance companies.
  • Utilizing medical provider portals to obtain authorizations.
  • Utilize Athena and G2 systems.
  • Database updates.
  • Maintain patient confidentiality and security of patient information.

Health Information Specialist

Ciox Health
05.2020 - 06.2022
  • Receive and process medical records requests for patient health information with company and facility policies and procedures.
  • Maintain confidentiality and security with all privileged information.
  • Maintain working knowledge of company and facility software.
  • Responsible for managing patient's records.
  • Prepare new patient's charts, gathering documents and information from paper sources and/or electronic health records.

Referral Specialist

Medical Associates Plus
05.2019 - 05.2020
  • Prepare patients referrals to specialists for services and/or procedures.
  • Obtain insurance referrals via telephone and online provider portals.
  • Schedule patients for diagnostic testing and procedures.
  • Referral follow up management.

Authorization Specialist/ Front Desk Reception

University Open MRI
05.2017 - 05.2020
  • Verify patient eligibility and benefits via provider portals.
  • Obtain insurance authorization by submitting clinical information for MRI procedures.
  • Assist the front desk with check in/check out duties and scheduling patients.

Referral Specialist

Tidewater Physicians Multispecialty Group
04.2010 - 05.2017
  • Prepare patient referrals to specialists for services and/or procedures.
  • Schedule patients for diagnostic imaging and specialty services.
  • Obtain authorization and online insurance referrals.
  • Database updates.

Education

Career Studies Certificate - Early Childhood Education

Thomas Nelson Community College
Hampton, VA
05.1993

HIMS

Miller Motte College
Augusta, GA
06.2022

Skills

  • Patient appointment coordination
  • Document analysis
  • ICD-10 coding expertise
  • Proficient in Microsoft Office
  • Health information organization
  • Proficient in medical terminology
  • Epic management
  • Insurance eligibility verification
  • Comprehensive anatomy understanding
  • CPT code proficiency
  • Expertise in HIPAA standards
  • Strong customer support skills
  • Health insurance verification
  • Effective time management

Timeline

Care Access Coordinator

Optum
12.2024 - Current

Insurance Verification Coordinator

Riverside Health Services
09.2023 - 06.2024

Clinical Insurance Reviewer

Physician Reliance Network/McKesson Healthcare Company/Maryland Oncology Hematology
07.2022 - 09.2023

Health Information Specialist

Ciox Health
05.2020 - 06.2022

Referral Specialist

Medical Associates Plus
05.2019 - 05.2020

Authorization Specialist/ Front Desk Reception

University Open MRI
05.2017 - 05.2020

Referral Specialist

Tidewater Physicians Multispecialty Group
04.2010 - 05.2017

HIMS

Miller Motte College

Career Studies Certificate - Early Childhood Education

Thomas Nelson Community College