Ghyselaine Sheehan
Punta Gorda,US
Summary
Hardworking Patient Account Representative dedicated to customer service and patient care. Outgoing and flexible team player. Talent for developing creative solutions that satisfy all parties. Motivated Patient Account Representative offering 30 years of healthcare and customer service experience. Highly effective time management, conflict resolution and communication skills
Overview
35
35
years of professional experience
Work History
Sales Associate
Goodwill
07.2024 - Current
- Boosted customer satisfaction levels through exceptional service, addressing concerns promptly, and providing a welcoming store environment.
- Handled cash transactions efficiently while adhering to company cash handling policies, ensuring accuracy in all financial exchanges.
- Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
Patient Account Specialist
MedPro Solutions
10.2008 - 10.2011
- Assisted patients in understanding their financial responsibilities by explaining healthcare benefits, coverage limitations, and out-of-pocket costs clearly and concisely.
- Ensured compliance with all applicable laws, regulations, policies governing medical billing practices, and patient privacy by staying current on industry changes.
- Processed all claims for West Florida Medical Center Clinic, Pensacola Primary Care Inc, and Gulf Coast Radiology Oncology.
- Researched and resolved all denied claims.
Patient Account Specialist
Scenic Health Alliance
07.2008 - 10.2008
- Assisted patients in understanding their financial responsibilities by explaining healthcare benefits, coverage limitations, and out-of-pocket costs clearly and concisely.
- Responsible for follow up claims to include Personal Injury and Workers Comp claims. Involved sending out requested documentation to Auto Insurance Carriers and Attorneys. Entered charges and provided training in processing and billing insurance for new staff members.
- Enhanced team productivity by sharing knowledge, best practices, and providing cross-training opportunities for colleagues in the Patient Accounts Department.
Patient Account Specialist
Sacred Heart Medical Group
02.2003 - 07.2008
- Assisted patients in understanding their financial responsibilities by explaining healthcare benefits, coverage limitations, and out-of-pocket costs clearly and concisely.
- Improved cash flow by consistently meeting or exceeding collection targets through proactive account monitoring and follow-up efforts.
- Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records.
- Contributed to departmental goals for lowering A/R days by prioritizing accounts based on aging reports, taking appropriate action steps to expedite collections or adjustments as needed.
- Safeguarded patient confidentiality while handling sensitive financial information by adhering to strict HIPAA regulations and organizational privacy policies.
- Posted payments and processed refunds.
- Enhanced patient satisfaction by efficiently managing billing inquiries and resolving discrepancies.
Medical Insurance Specialist
Randall P. Riche, M.D., P.A Endocrinologist
07.1998 - 12.2003
- Achieved timely resolution of claim issues through effective communication with insurance carriers and healthcare providers.
- Provided exceptional customer service, assisting patients in understanding their insurance benefits and financial responsibilities.
- Supported team members in professional growth, providing guidance on complex billing scenarios as needed.
- Posted payments, prepared deposits and issued refund.
- Increased patient satisfaction by efficiently processing insurance claims and addressing inquiries. Negotiated Insurance Contracts new Providers.
- Dailey back-up, prepared month end, quarterly and year end reports for doctor and accountants.
- Set up appointments for outside tests and surgeries
- Increased patient satisfaction by efficiently processing insurance claims and addressing inquiries.
- Checked in, checked out patients and answered phones as needed.
Insurance Department Supervisor
Martin and Plunkett, M.D., P.A. Urologists
07.1996 - 07.1998
- Mentored junior staff members to develop their skills and advance within the company, increasing overall productivity and team performance.
- Managed team of four employees, delegated tasks and held each employee accountable for completing assignment.
- Promoted a culture of continuous improvement through frequent process reviews, open dialogue among team members about potential enhancements, and proactive implementation of changes.
- Trained new employees on overall company and department-specific policies and procedures.
- Educated staff on strategies for handling difficult customers and challenging situations.
Assistant Office Manager
Shao, Gincauskas, Bentz & Nalley, Anesthesiologist
03.1990 - 07.1996
- Conferred with insurance company representatives to expedite payments and resolve filing issues, keeping aging balances low and office finances strong.
- Served as liaison between management and staff, effectively resolving conflicts and fostering positive relationships.
- Assisted in recruitment efforts, interviewing candidates and onboarding new hires for a seamless transition into company.
- Credentialed new Providers, processed AR month end, processed AP on a weekly basis.
- Posted charges, processed claims and ran reports to work identify claims were paid timely. We had a 97% collection rate. I was in charge of computer maintenance and software installation. Negotiated fee schedules with insurance Companies
- Cultivated a professional atmosphere by maintaining open lines of communication among team members.
Education
Business Administration And Management
Pensacola State College
Pensacola, FLHigh School Diploma -
Fair Haven Union High School
Fair Haven, VT06.1971
Skills
- Patient Care
- HIPAA Compliance
- Financial Counseling
- Team Collaboration
- Patient account management
- Medical Terminology
- Payment Processing
- Insurance Verification
- Verbal and written communication
Timeline
Sales Associate
Goodwill
07.2024 - Current
Patient Account Specialist
MedPro Solutions
10.2008 - 10.2011
Patient Account Specialist
Scenic Health Alliance
07.2008 - 10.2008
Patient Account Specialist
Sacred Heart Medical Group
02.2003 - 07.2008
Medical Insurance Specialist
Randall P. Riche, M.D., P.A Endocrinologist
07.1998 - 12.2003
Insurance Department Supervisor
Martin and Plunkett, M.D., P.A. Urologists
07.1996 - 07.1998
Assistant Office Manager
Shao, Gincauskas, Bentz & Nalley, Anesthesiologist
03.1990 - 07.1996
Business Administration And Management
Pensacola State College
High School Diploma -
Fair Haven Union High School
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