Donna LYLE
Opp,AL
Summary
Dedicated healthcare professional with extensive expertise in patient registration and record management, specializing in insurance verification and prior authorizations. Proficient in managing confidential information while ensuring strict compliance with industry policies. Recognized for strong collaborative skills and a commitment to delivering consistent, high-quality results that enhance patient care and operational efficiency. Passionate about contributing to a positive healthcare experience through effective communication and teamwork.
Overview
13
13
years of professional experience
Work History
Pre Reg Registrar
Mizell Memorial Hospital
Opp, AL
10.2024 - 03.2026
- Managed scheduling of appointments, optimizing resource allocation and enhancing patient access to services.
- Organized, reviewed, and filed paperwork for secure recordkeeping.
- Greeted every guest with personable approach and provided knowledgeable service.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Verified paperwork accuracy and checked for completion prior to processing.
- Updated computer system with latest information to keep records current and accurate.
- Coordinated patient billing inquiries ensuring timely resolution of financial issues
- Implemented streamlined processes to enhance patient account management efficiency
- Collaborated with healthcare providers to verify insurance eligibility and coverage details
- Educated patients on financial options, improving understanding of payment plans
- Provided compassionate support to families facing financial hardships due to medical expenses, helping them identify resources for assistance.
- Reduced claim denials, ensuring accuracy in insurance verification and pre-authorization processes.
- Maintained strict confidentiality of patient information while adhering to HIPAA regulations throughout all interactions and communications.
- Worked closely with clinical departments on case-by-case basis when coordinating charity care applications, ensuring timely submission and approval.
- Improved patient satisfaction by efficiently addressing and resolving billing-related inquiries.
- Assisted patients in understanding their benefits and coverage, clarifying complex insurance terms, and providing guidance on out-of-pocket expenses.
- Assessed patients'' eligibility for financial assistance programs by conducting thorough reviews of their income and expenses, making appropriate recommendations based on individual circumstances.
- Collaborated with clinical teams to optimize patient care coordination and financial management.
- Answered incoming calls, scheduled appointments and filed medical records.
- Verified patient insurance eligibility and entered patient information into system.
- Provided excellent customer service to patients and medical staff.
- Greeted and assisted patients with check-in procedures.
- Followed document protocols to safeguard confidentiality of patient records.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Facilitated communication between patients and various departments and staff.
- Engaged with patients to provide critical information.
- Responded to inquiries by directing calls to appropriate personnel.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Resolved customer complaints using established follow-up procedures.
- Delivered support to medical staff in completion of patient paperwork.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Updated patients'' financial records promptly after receiving payments or adjustments, ensuring timely reporting of account status changes.
- Oversaw patient registration processes, ensuring compliance with healthcare regulations and policies.
- Collaborated with clinical teams to verify insurance eligibility and coordinate benefit information for patients.
LPN Field Nurse
Gentiva Home Health
Crestview, FL
01.2019 - 10.2020
- Administered medications and treatments according to patient care plans.
- Collaborated with interdisciplinary teams to optimize patient outcomes.
- Conducted comprehensive assessments to identify patient needs and concerns.
- Educated patients and families on health management and disease prevention.
Regional Admissions Coordinator
Kindred Healthcare Hospice
Ocala, FL
12.2017 - 10.2018
- Followed up with and contacted previous patients/caregivers and those not appropriate at first contact via phone. Made daily phone calls.
- Entered contact results into computer system for each individual.
- Entered details such as patient and insurance information and call logs into the computer system.
- Responded to customer/patient requests via telephone and email.
- Worked directly with Sales and Nursing Management to achieve appropriate admissions.
- All duties were done for up to 7 offices.
Admission Coordinator
Emerald Coast Hospice (managed By Kindred Healthcare)
Marianna, FL
10.2017 - 12.2017
- Received patient referrals via computer, email, phone. Verified information and MD order.
- Obtained all medical records related to patient referral. Contacted MD offices and facilities to obtain and scanned into computer system/patient chart.
- Verified all insurances i.e., Medicare, Medicaid, Tricare and private insurances. Obtained authorizations if required. Entered all information into computer system.
- Copied, logged and scanned supporting documentation.
- Contacted Nursing Management for approval and then contacted patient and/or caregiver to arrange time for informational meeting and admission, if appropriate.
- Responded to customer requests via telephone and email.
Site Revenue Coordinator
Emerald Coast Hospice (managed By Kindred Healthcare)
Chipley/Marianna, FL
05.2015 - 10.2017
- Entered patient/client billing data, nursing home rates, level of care, per diem and physician billing or charges, fee for service charges, verified discharge and admission data.
- Coordinated and reviewed documentation and date entry supporting Medicare, Medicaid and commercial payer requirements to ensure accurate and timely billing.
- Coordinated and reviewed account receivable tracking tools and maintained account receivable files in order to ensure accurate and timely claim submission and to prevent lost revenue.
- Ensured eligibility is confirmed and paperwork was accurate and submitted timely to prevent lost revenue.
- Maintained tracking tools to ensure eligibility, insurance verification, authorizations, certifications and re-certifications for Medicaid and room and Board payments.
- Assisted in preparation of monthly reports to ensure accracy and timely processing of claims billed. Maintained bill hold report to resolve outstanding items that prevented billing.
- Participated in weekly A/R review .
- Provided back up for Admissions Coordinator.
Patient Care Secretary
Emerald Coast Hospice (managed By Kindred Healthcare)
Chipley/Marianna, FL
02.2013 - 04.2015
- Maintained patient assignment list including but not limited to making change notices on status of patients.
- Verified accuracy of date entry from completed admissions.
- Filed and kept medical records current.
- Printed and distributed current census.
- Maintained on call back with up to date information.
- Prepared copies, notes to physicians for MD's and Patient Care Managers for upcoming re-certifications for Medicare.
- Participated in staff meetings, department meetings, team meetings, in services.
- Daily data entry. Heavy phone use daily.
Education
Associate of Arts - Nursing
NE Mississippi Community College
Corinth, Mississippi1993
Skills
- Document scanning
- Report writing
- Client assessment and analysis
- Extremely organized
- Process implementation
- Clerical support
- Self-motivated
- Data management
- Strong verbal communication
- Data entry
- Interpersonal and written communication
- Skilled in Microsoft, Power Point, Horizon
Timeline
Pre Reg Registrar
Mizell Memorial Hospital
10.2024 - 03.2026
LPN Field Nurse
Gentiva Home Health
01.2019 - 10.2020
Regional Admissions Coordinator
Kindred Healthcare Hospice
12.2017 - 10.2018
Admission Coordinator
Emerald Coast Hospice (managed By Kindred Healthcare)
10.2017 - 12.2017
Site Revenue Coordinator
Emerald Coast Hospice (managed By Kindred Healthcare)
05.2015 - 10.2017
Patient Care Secretary
Emerald Coast Hospice (managed By Kindred Healthcare)
02.2013 - 04.2015
Associate of Arts - Nursing
NE Mississippi Community College