Ieisha Washington-Bradford
Atlanta,GA
Summary
Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.
Overview
8
8
years of professional experience
Work History
Clinical Care Navigator
United Health Group
06.2021 - Current
- Outreached members on caseload consistent with program guidelines.
- Complete all required data entry into the appropriate systems to include formatting, auditing, and tracking of completed assignments.
- Completes telephonic outreach to DSNP members utilizing auto dialer and manual dialing
- Educates members on gaps in care and assists with scheduling provider appointments.
- Maintains confidential health information according to state and federal regulations including HIPAA
- Attend team meetings as required and participate in discussions and process improvement projects.
- Meet the performance goals established for the position in the areas of productivity, quality, and attendance.
- Maintain flexibility in an ever-changing environment
- Answer incoming calls from our members as needed
- Delivered support to medical staff in completion of patient paperwork.
- Resolved customer complaints using established follow-up procedures.
- Verified patient insurance eligibility and entered patient information into system.
- Facilitated communication between patients and various departments and staff.
- Identified gaps in care and assisted in closure of gaps.
- Utilized Microsoft Word to edit, create and save confidential documents.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Benefits Support Specialist
CareSource Health Plan
02.2017 - 06.2021
- Collaborate with healthcare providers and insurance companies to resolve discrepancies and expedite claims processing
- Coordinate patient benefits and insurance eligibility for over 70 patients daily, ensuring timely and accurate verification and authorization of services
- Educate patients on their insurance benefits, coverage options, and financial responsibilities, enhancing patient understanding and satisfaction
- Maintain accurate and up-to-date records in the electronic medical record system, ensuring compliance with HIPPA regulations
- Assist in the appeals process for denied claims, researching and providing necessary documentation to support resolutions
- Managed patient inquiries via telephone and email regarding insurance benefits and billing, providing clear and concise information to enhance understanding
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
Education
High School Diploma -
South Cobb High School
Austell, GA05.2010
Skills
- Proficient in Windows Operating Systems
- Excel and Outlook Expertise
- Billing Coordination
- Insurance Claims Processing
- ICD-10 Management
- Care coordination
- Data entry
- Insurance verification
- Claims resolution
- Electronic records management
- Customer service
- Healthcare systems
- Medical terminology
Timeline
Clinical Care Navigator
United Health Group
06.2021 - Current
Benefits Support Specialist
CareSource Health Plan
02.2017 - 06.2021
High School Diploma -
South Cobb High School
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