Honeca Walcott
764 Leonardo Ct. Kissimmee,FL
Summary
Dedicated and qualified individual with 15+ years of experience in a fast-paced provider, member service and call center environments, personable and professional under pressure. Motivated to maintain customer satisfaction and help contribute to company success.
Overview
10
10
years of professional experience
Work History
Patient Care Coordinator
Lifestances Health
06.2023 - Current
- Maintained confidentiality of patient data and condition to safeguard health information.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
- Worked closely with patients to deliver excellent and direct individualized patient care.
- Developed and maintained positive relationships with clients to create safe and supportive environment.
- Aided colleagues, managers, and customers through regular communication, emails and assistance.
- Created and updated physical records and digital files to maintain current, accurate, and compliant documentation.
- Screened and transferred incoming calls, took down messages, and transmitted information and documents to internal personnel.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Processed payments and applied to customer balances.
- Negotiated re-payment plans by identifying causes of delinquent payments to assist in recovery of debt and meet realistic timeframes.
Provider/Member Advocate
United Healthcare, UHG
05.2016 - 06.2023
- Quickly and appropriately triage contacts from healthcare professionals (i.e. physician offices, clinics, billing offices).
- Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g. benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health).
- Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls, escalations, and provider dissatisfaction.
- Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues.
- Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution.
- Responds to incoming, telephonic, written or email inquiries from customers or providers regarding eligibility, benefits, claim status/issues, policies & procedures, reimbursement, claims filing and/or appeals/grievances.
- Ensures the delivery of excellent customer service.
- Conducts data entry and claims processing/issues.
- Ability to handle most claim types / cases / issues that are submitted.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained confidentiality of patient finances, records and health statuses.
- Reviewed provider coding information to report services and verify correctness.
- Paid or denied medical claims based upon established claims processing criteria.
- Submitted electronic/paper claims documentation for timely filing.
Patient Access Specialist
AssistRx
03.2022 - 09.2022
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Obtained signatures from financial responsibility and treatment procedures from patients or guardians.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Facilitated communication between patients and various departments and staff.
- Identified prospect needs and developed appropriate responses along with information on suitable products and services.
- Acted as main point of contact for patients, doctors and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
- Worked closely with patients to deliver excellent and direct individualized patient care.
- Monitored ongoing care and proactively corrected problems.
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Helped patients receive appropriate, high-quality care with reasonable results.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
DME Intake Coordinator
Univita Health
01.2014 - 11.2015
- Demonstrates knowledge of home care regulations (CMS and AHCA) and remain current on updates and changes to regulations.
- Handles escalated issues, mobilizing necessary resources to promptly resolve problems.
- Process DME orders and closely monitor deadlines and deliverables to ensure compliance with health plan client requirements.
- Act as primary liaison between Univita and assigned heath plan client while maintaining close interactions with other departments including nursing, pharmacy, and compliance to ensure client and member needs are met.
- Review documented claim forms and contacts insured, insured's representative, or provider to request information needed to process benefit inquiry.
- Demonstrates thorough understanding of Univita health plan contract in order to ensure that services are delivered as required and health plan and members expectations are consistently met or exceeded.
Education
High School Diploma -
Cornerstone Christian Academy
Townsend, GA06.2001
Skills
- Strong verbal and written communication skills
- Microsoft Office, OneNote
- Microsoft Word, Outlook
- PowerPoint, Excel, Microsoft Teams
- Medical Terminology Knowledge
- Data entry, Claims reviewing
- Portico, Facets, Salesforce
- Multitasking Abilities
Timeline
Patient Care Coordinator
Lifestances Health
06.2023 - Current
Patient Access Specialist
AssistRx
03.2022 - 09.2022
Provider/Member Advocate
United Healthcare, UHG
05.2016 - 06.2023
DME Intake Coordinator
Univita Health
01.2014 - 11.2015
High School Diploma -
Cornerstone Christian Academy
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