Hillary Benton
Winder,GA
Summary
Efficient Precertification Specialist with expertise in insurance verification, medical coding (ICD-10, CPT), and patient records management. Exceptional communication, time management, and problem-solving skills to streamline pre-authorization processes for seamless patient care coordination and accurate billing.
Overview
14
14
years of professional experience
Work History
Precertification Specialist
Gastroenterology Specialists of Gwinnett, PC
Lawrenceville, GA
04.2024 - Current
- Analyzed patient medical records to establish the medical necessity of requested services and procedures.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submitting precertification requests.
- Maintained compliance with established timelines by compiling and submitting precertification requests for payer review.
- Ensured timely processing by providing follow-up on pending precertification requests.
- Documented all activities concerning the precertification process meticulously.
- Maintained adherence to applicable laws, regulations, policies, and procedures in the healthcare industry.
- Highlighted gaps in the pre-approval system and implemented effective remedies.
- Ensured compliance with all HIPAA regulations pertaining to protected health information.
- Communicated reasons for denied applications and suggested corrective measures.
- Coordinated with other departments to promote prompt processing of client applications.
- Ensured the timely transmission of medical records and correspondence via mail, e-mail, or fax.
Call Center Representative - Remote
Enablx
Orlando, FL
01.2022 - 03.2024
- Complied with all customer privacy regulations and laws.
- Developed effective relationships with team members from various departments.
- Responded to customers' incoming calls promptly while addressing their product queries, billing concerns, and other customer service issues effectively.
- Provided timely resolution to customer issues, ensuring their ongoing satisfaction.
- Ensured compliance with applicable laws governing the billing process.
- Processed guest payments and ensured accurate billing.
Office Clerk/ Check-In & Translator
Gastroenterology Specialists of Gwinnett, PC
01.2021 - 01.2021
- Answered phone calls in a professional manner and transferred calls accordingly.
- Confirmed patient arrival and checked insurance information for accuracy.
- Maintained an accurate and up-to-date patient database containing contact details, medical records, and appointment schedules.
- Translated medical documents, such as patient records, insurance forms and legal documents, from French to English.
Reflexologist
Foot Palace, LLC.
05.2018 - 01.2021
- Delivered individualized therapeutic reflexology treatments based on clients' specific requirements.
- Applied pressure to specific points on the feet, hands and ears to relieve tension and pain.
- Educated clients on the benefits of reflexology and its ability to improve overall well-being.
- Performed foot baths with essential oils or herbs to promote relaxation and healing.
- Cleaned and maintained work area between sessions in order to ensure a safe environment for clients.
- Adhered to all applicable state regulations governing the practice of reflexology.
Barista
Starbucks Company
10.2010 - 11.2018
- Greeted customers and took orders for coffee drinks, food items, and other beverages.
- Operated cash registers to process customer payments.
- Maintained a clean work environment by wiping down counters, washing dishes, and cleaning floors.
- Followed safety procedures while operating machinery such as grinders and espresso machines.
- Provided new hires with comprehensive training on company policies and proper food handling procedures.
- Maintained composure in fast-paced environments, including high-volume periods and special events.
- Ensured brand loyalty through the resolution of customer concerns.
Education
Certificate -
Atlanta International Language Institute
12.2015
High School Diploma -
Faith Academy
05.2012
Skills
- Microsoft Windows OS
- Linux OS
- MacOS
- Integrative Reflexology
- Appointment Scheduling
- Data Analytics
- Micro/Macro-Data Management
- Social Networking Media
- AllScripts EMR & PM
- Software: Availity
- Medical Readings: Vitals
- Patient Screening
- Medical Terminology
- Medical Anatomy
- Medical Physiology
- Troubleshooting
- Electronic Health Records Management
- Medical terminology proficiency
- Conflict resolution techniques
- Applicant support and service
- Proficiency in Sugar
- Telephone Etiquette
- Effective communication skills
- Data Entry
- Interviewing techniques
- Disability Awareness
- Policy Interpretation
- Documentation And Reporting
- Microsoft Office
- Income verification
- Benefits Administration
- Confidentiality
- Medicaid knowledge
- Government relations
- Application assessment
- Recordkeeping and data input
- Documentation and paperwork
Personal Ethics & Work Ethic Skills
- Organization
- Eager Work Ethics
- Leadership Behavior
- Enlightened Negotiator
- Problem-Solving
- Teamwork
- Communication: Persuasive
- Motivated Work-Style
- Flexibility/Adaptability
- Project Management
- Time Oriented/Management
- Critical Thinker
- Korean/English Translator
- Recreational Background
Timeline
Precertification Specialist
Gastroenterology Specialists of Gwinnett, PC
04.2024 - Current
Call Center Representative - Remote
Enablx
01.2022 - 03.2024
Office Clerk/ Check-In & Translator
Gastroenterology Specialists of Gwinnett, PC
01.2021 - 01.2021
Reflexologist
Foot Palace, LLC.
05.2018 - 01.2021
Barista
Starbucks Company
10.2010 - 11.2018
Certificate -
Atlanta International Language Institute
High School Diploma -
Faith Academy
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