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
2024.04 - 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
2022.01 - 2024.03
- 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
2021.01 - 2021.01
- 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.
2018.05 - 2021.01
- 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
2010.10 - 2018.11
- 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
2024.04 - Current
Call Center Representative - Remote
Enablx
2022.01 - 2024.03
Office Clerk/ Check-In & Translator
Gastroenterology Specialists of Gwinnett, PC
2021.01 - 2021.01
Reflexologist
Foot Palace, LLC.
2018.05 - 2021.01
Barista
Starbucks Company
2010.10 - 2018.11
Certificate -
Atlanta International Language Institute
High School Diploma -
Faith Academy
Similar Profiles
Vincent GuzmanVincent Guzman
Medical Assistant at Israel Aviles MD PC GastroenterologyMedical Assistant at Israel Aviles MD PC Gastroenterology
Elizabeth LesterElizabeth Lester
Billing Manager at Athens Gastroenterology Center PCBilling Manager at Athens Gastroenterology Center PC
Kimberly SkorupaKimberly Skorupa
Phone Operator at Mercer Gastroenterology, PCPhone Operator at Mercer Gastroenterology, PC