Summary
Overview
Work History
Education
Skills
Personal Ethics & Work Ethic Skills
Timeline
Generic

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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Hillary Benton