Erika Wells Gayfield
Florissant,Missouri
Summary
Experienced healthcare worker with 20 plus years of Revenue Cycle, Billing, Patient Access, Insurance Verification, Customer Service, Patient Support Skills, Health Information Management, Patient Advocacy and MEP. I have worked in several departments in healthcare over the years and I am continuing my education so that I can excel within the Healthcare Industry.
Overview
17
17
years of professional experience
Work History
Patient Care Coordinator/Patient Access Representative
SSM Health St. Mary's Hospital/SLU Hospital
St Louis, MO
08.2019 - Current
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Determined patients financial needs and referred eligible patients to proper agencies to obtain financial assistance.
- Completed full registration, while verifying patient's information and obtaining signatures for financial responsibility and treatment procedures from patient's.
- Performed patient scheduling functions for add on patient's and have directed to main scheduling department for future testing or office visits.
- I have followed document protocols to safeguard confidentiality of patient records.
- Performed insurance verification and price transparency.
Patient Care Coordinator
Optum/SSM
St Louis, MO
02.2022 - 12.2023
- Coordinated patient care services with the medical team to ensure quality and timely delivery of care.
- Assisted in creating a positive environment for patients, family members, and staff by providing excellent customer service.
- Scheduled appointments for patients and coordinated follow-up visits as needed.
- Maintained accurate records of all patient care activities using electronic health record systems.
- Performed administrative duties such as filing paperwork, answering phones and scheduling appointments.
- Ensured that all necessary documentation was completed accurately and submitted in a timely manner.
- Processed patient intake information and updated medical records prior to treatment.
- Completed insurance verifications and claim forms for patient intake and processing.
- Provided administrative support for patient care staff.
- Established strong work network by building professional relationships with physicians and fellow employees.
- Explained policies, procedures and services to patients.
- Calculated sliding fee or special program adjustments relating to patient visits.
- Obtained informed consent and payment documentation from patients and filed in system.
- Organized timely and accurate referrals to help patients obtain health care services and access available resources.
Admitting Clerk
St. Alexius/South City Hospital
St Louis, MO
03.2007 - 03.2021
- Verified patient information and insurance verification
- Admitted patients for direct admissions
- Coordinated patient paperwork and charts.
- Determined charges and collected co-pays.
- Managed patient admissions and discharge from hospital to home care, extended care facility or self-care.
- Verified schedules and arrival times.
- Completed registrations for laboratory work, surgical procedures and radiology.
- Created and maintained accurate and confidential patient files according to regulatory mandates.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Contacted other medical facilities to confirm medical histories and prevent inaccurate diagnoses.
- Managed incoming telephone calls, took messages and directed callers to personnel.
- Transcribed physicians' notes and entered data into electronic chart management software.
- Assisted with hospital admissions and paperwork.
- Helped patients complete paperwork and explained processes and procedures.
- Updated patient financial information to promote accurate record keeping.
- Communicated with patients to gather intake data and verify chart information.
Business Analyst
Centene
Chesterfield, MO
04.2017 - 06.2019
- Manipulated data using pivot tables, pivot charts and macros in Excel.
- Pinpointed inefficiencies in business processes and recommended improved policies.
- Reconciled and reported record discrepancies to prepare for annual audit.
- Diminished project gaps to facilitate smooth inventory workflow while reducing task duplication.
- Identified and analyzed business strategies to increase company longevity.
- Computed, recorded and proofread data in preparation of records and reports.
Lead Patient Access Specialist
SSM St. Louis University Hospital
St Louis, MO
03.2011 - 04.2017
- Reviewed patient admissions to determine medical necessity as directed by department criteria.
- Scheduled and implemented patient admissions and discharges.
- Applied HIPAA privacy and security regulations while handling patient information.
- Verified demographics and insurance information to register patients in computer system.
- Organized and maintained records by updating and obtaining both personal and financial information from patients.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Responded to patient concerns and inquiries professionally and efficiently.
- Assembled registration paperwork and placed identification bands on patient.
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
- Processed patient responsibility estimate determined by insurance at pre-registration.
- Called insurance companies and verified patient coverage.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Obtained health, financial and religious information from patients at time of admission.
- Interviewed patients upon entrance to hospital, gathered appropriate information and entered data into electronic system.
- Communicated financial obligations to patients and collected fees at time of service.
- Trained facility volunteers on guest relations procedures and patients' rights.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Addressed patients' complaints-head on, investigated concerns and worked with medical staff to devise solutions.
- Facilitated communication between patients, medical and administrative staff, administrative staff and regulatory agencies.
- Explained policies, procedures and services to patients.
- Used sliding payment scale to assess fair charges for patient healthcare.
Education
High School Diploma -
O'fallon Township High School
O'Fallon, IL05.2000
Some College (No Degree) -
Forest Park Community College
Skills
- Epic
- Meditech
- Pbar
- Ace Star
- Microsoft Word
- Microsoft Excel
- Microsoft PowerPoint
- VI WEB
- Citrix
- Portico
- Amisys
- Microstrategy
- Passport
- HBOC
- Care Ready
Timeline
Patient Care Coordinator
Optum/SSM
02.2022 - 12.2023
Patient Care Coordinator/Patient Access Representative
SSM Health St. Mary's Hospital/SLU Hospital
08.2019 - Current
Business Analyst
Centene
04.2017 - 06.2019
Lead Patient Access Specialist
SSM St. Louis University Hospital
03.2011 - 04.2017
Admitting Clerk
St. Alexius/South City Hospital
03.2007 - 03.2021
High School Diploma -
O'fallon Township High School
Some College (No Degree) -
Forest Park Community College
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