Erica McMillan-Pettyjohn
Summary
Friendly insurance professional experienced in investigating and processing insurance claims. Hardworking and communicative individual excels at interpreting policies and negotiating payment solutions. Recognized for providing optimum service to policyholders and quickly identifying fraudulent claims.
Overview
29
29
years of professional experience
Work History
Claims Specialist
Bako Pathology Associates
11.2020 - Current
- Responsible for performing account follow up activities to resolve invoice balances.
- Completing minimum of 50 claims per day
- Understanding of revenue cycle process, from patient data entry to financial services.
- Strong communication sills, analytical reasoning, and ability to identify missing/incomplete patient/insurance demographics Followed up with customers on unresolved issues.
- Consistently meet and establish productivity.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
Administrative Assistant
Christiana Care Health Systems
11.2019 - 11.2020
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Interview of 20+ patients for case histories in advance of appointments
- Transfer lab results, imaging results, STAT results, etc. to appropriate clinician.
- Oversee provider schedules and block according to meetings, conferences, etc. In addition, arranging specialty and hospital appointments.
- Working with Geriatric population either home bound, skilled nursing facility, or independent living.
Insurance Verification Specialist
A.I. DuPont Hospital For Children
10.2009 - 11.2019
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Balancing daily schedule of 25+ patients
- Assisted patients with understanding personalized insurance coverage and benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Medical Secretary II
A.I. DuPont Hospital For Children
10.2009 - 11.2019
- Answered phone calls and messages for 40+ patients in pediatric medical facility, scheduling appointments, and handling patient inquiries
- Minimum of 50 calls per day
- Kept information confidential and followed HIPAA guidelines to maintain patient trust.
- Organized paperwork such as charts and reports for office and patient needs.
- Maintained current and accurate medical records for patients.
- Obtain authorizations and pre-certifications for upcoming visits/procedures.
- Collected, arranged, and input information into database system
- Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments
Anesthesia Core Technician
Children's Hospital Of Philadelphia, CHOP
09.1994 - 02.2004
- Supported Surgeons and nurses with surgery techniques and procedures.
- Approximately 4-6 procedures scheduled at one time.
- Verified availability of operating room supplies, medications and gases.
- Maintained sterile anesthesia supplies within expiration date.
- Followed infection control procedures to maintain cleanliness of anesthesia monitors and apparatuses.
- Maintained and cleaned anesthesia machines by changing soda-lime, refilling vaporizers with anesthetic agents and replacing nitrous, oxygen and air cylinders
- Assisted with transports of invasively monitored O.R. and I.C.U. patients
- Educated patients and families about procedures, risks and benefits of anesthesia
- Assisted anesthesia personnel with insertion and setup of temporary pacemakers, catheters, invasive monitoring lines and central lines for hemodynamic monitoring
Education
Bachelor of Science - Behavioral Science
Wilmington Universityy
New Castle, DE12.2023
Certificacte - Medical Office Specialists
Consolidated School of Business
Lancaster, PA06.1992
Skills
- Group Dynamics
- Patient Rapport
- Intake Assessment
- Data-Driven Decision-Making
- Assisting with Case Histories
- Employee Training
Timeline
Claims Specialist
Bako Pathology Associates
11.2020 - Current
Administrative Assistant
Christiana Care Health Systems
11.2019 - 11.2020
Insurance Verification Specialist
A.I. DuPont Hospital For Children
10.2009 - 11.2019
Medical Secretary II
A.I. DuPont Hospital For Children
10.2009 - 11.2019
Anesthesia Core Technician
Children's Hospital Of Philadelphia, CHOP
09.1994 - 02.2004
Bachelor of Science - Behavioral Science
Wilmington Universityy
Certificacte - Medical Office Specialists
Consolidated School of Business
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