Holly Schultz
Rome
Summary
Professional with strong background in claims management, prepared to make significant impact. Skilled in assessing and processing claims accurately, resolving complex issues, and ensuring customer satisfaction. Effective team collaborator with focus on achieving results and adapting to changing needs. Known for analytical thinking, communication skills, and attention to detail.
Overview
8
8
years of professional experience
Work History
Claims Representative
Harbin Clinic
10.2023 - Current
- Processed claims efficiently, ensuring compliance with organizational policies and state regulations.
- Evaluated and resolved complex claims inquiries, enhancing customer satisfaction through effective communication.
- Collaborated with healthcare providers to verify patient information and claim accuracy, minimizing discrepancies.
- Trained new staff on claims processing procedures, improving team productivity and knowledge retention.
- Implemented process improvements that streamlined workflows, reducing claim processing time significantly.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
Referral Specialist
Highland Rivers Behavioral Health
12.2021 - 11.2023
- Is the primary contact for all external referrals
- Manages external referral accounts by downloading referrals received daily.
- Maintains monthly data.
- Works closely with managers and other liaison staff working with community stakeholders who are sending referrals to foster a smooth and timely linkage to services for individuals.
- Schedules appointments with adherence to current processes in an effort to best serve our individuals.
- Processes telephone calls and messages promptly with strict adherence to confidentiality, policies, and procedures.
- Enters data, documents, and relevant interactions with individuals served in a concise and thorough manner in electronic health record.
Scheduler
Highland rivers health
11.2020 - 12.2021
- Promptly answers, screens, and processes telephone inquiries with strict adherence to confidentiality and policies and procedures.
- Reschedule and cancel appointments as needed.
- Return all call center messages in a timely manner.
- Collects and enters patient information into the Care Logic system in a concise, thorough, and accurate manner.
- If applicable, ensures consumers are referred to the clinical team for triage.
- Utilizes computer software to schedule appointments.
- Use initiative and good, sound judgment.
- Maintain current and up to date data concerning schedules, accepted coverage, and any pertinent information.
- Meet the expectations of our internal and external customers in providing excellent service.
Dental Receptionist
Kind Care Dentistry
11.2019 - 11.2020
- Prepared claim forms for dental insurance.
- Scheduled appointments for new and existing patients, factoring in provider availability and scheduling loads.
- Helped dental assistant complete routine and advanced procedures by preparing patients and handling instruments for expected needs.
- Adhered to strict HIPAA guidelines at all times to protect patient privacy.
- Organized referrals to other medical specialists.
- Taught patients successful strategies for boosting oral hygiene.
- Maintained and managed patient records in compliance with security regulations.
- Assisted patients in completing all necessary forms and documents.
- Greeted over 10 patients per day.
- Explained treatment procedures and instructed patients on home care guidelines.
- Booked appointments for patients using Open Dental.
- Documented patients' dental health information and medical history.
- Placed past due balances into collections on a monthly basis.
Human Service Worker
North East Florida State Hospital
08.2017 - 12.2018
- Educated potential participants on available services and processes to engage in program.
- Worked with clients to improve life choices and maximize benefits of programs.
- Utilized complex client management systems, both digital and manual and maintained sensitive information in a highly encrypted database.
- Understood and recognized signs of physical and substance abuse patterns and other debilitating circumstances.
- Adhered to strict client confidentiality laws and site-specific procedures to uphold privacy and provide the best experience possible.
- Prepared documents for review and completion by service applicants, supporting completion and responding to questions.
- Kept and established comprehensive case files to support proper documentation.
- Established positive relationships with aid recipients and assessed goals, working hard to address individual needs.
- Worked with others to manage numerous competing interests simultaneously and delegate accordingly to maximize productivity in everyday life.
- Acted as a mandatory reporter of abuse in confidential and conscious manner.
Education
Certification - Medical Assisting
Everest University
Orange Park, FL01.2020
Associate - Psychology
University of Phoenix
Orange Park, FL06.2013
GED - Basic Studies
Great Bridge High School
Chesapeake, VA05.2009
Skills
- Insurance Verification (3 years)
- Dental Receptionist (1 year)
- Chairside Assisting (Less than 1 year)
- Medical Billing (2 years)
- Dental Assisting (Less than 1 year)
- HIPAA (5 years)
- Medical Scheduling (3 years)
- Phone Etiquette (5 years)
- Medical Office Experience (5 years)
- Customer Service (5 years)
- Insurance claims review
- Claims investigation
- Time management
- Workers compensation
- Insurance regulations
- Claims trend analysis
- Customer service
- Attention to detail
Timeline
Claims Representative
Harbin Clinic
10.2023 - Current
Referral Specialist
Highland Rivers Behavioral Health
12.2021 - 11.2023
Scheduler
Highland rivers health
11.2020 - 12.2021
Dental Receptionist
Kind Care Dentistry
11.2019 - 11.2020
Human Service Worker
North East Florida State Hospital
08.2017 - 12.2018
Associate - Psychology
University of Phoenix
GED - Basic Studies
Great Bridge High School
Certification - Medical Assisting
Everest University
Section name
Authorized to work in the US for any employer