Iesha Mcalpine
Summary
Seeking an opportunity that will utilize my diverse skill-set and strong work ethic to make a impact in the lives of people. Also looking to continue to grow professionally in this career field.
Brings proven track record of success in determining eligibility and resolving complex cases.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Case Management Authorization Specialist IP
Emory University Hospital Midtown
03.2025 - Current
- Managing the process of obtaining insurance authorizations for inpatient and post-acute care services, ensuring the timely transition of patients to appropriate care settings and securing reimbursement for services by verifying eligibility, submitting documentation, and communicating with payers.
- Key duties include submitting admission and continued stay notifications, documenting medical necessity, tracking authorization status, and reconciling authorized versus actual patient days to prevent financial risk for the hospital and payment.
- Remain informed and comply with healthcare industry regulations, payer guidelines, and hospital policies(IMM/Moons).
Patient Access Associate / PRN
Piedmont Healthcare
03.2024 - Current
- Greet patients as they walk through the door
- Collect information from patients pertaining to their medical history, payment information and insurance
- Answer the questions of patients and their caregivers
- Submit patients insurance to get pre-approval for the care they require
- Perform other general administrative tasks as requested by supervisors
- Prepare patient admission and discharge documentation
- Coordinate check-in processes by contacting insurance providers to verify correct insurance information and get authorization for proper billing codes
Patient Access Representative II
Emory Healthcare
12.2021 - 03.2025
- Greet patients and their caregivers on arrival
- Prepare patient admission and discharge documentation
- Enter information into databases and maintain accurate records with the EPIC system
- Relay information to relevant staff members
- Inform patients and their caregivers of hospital procedures, policies, and protocols
- Deal with patient questions, concerns, and issues
- Perform general administrative tasks
- Provide patients with billing and payment information
- Collect information such as patient details, medical history, billing, and insurance information
Bank Teller
Wells Fargo
09.2018 - 12.2021
- Maintain and balance cash drawers and reconcile discrepancies
- Package cash and roll coins to be stored in drawers or the bank vault
- Handle currency, transactions, and confidential information in a responsible manner
- Follow all bank financial and security regulations and procedures
- Keep a clean, organized work area and a professional appearance
- Inform customers about bank products and services
- Assist customers with processing transactions, such as deposits, withdrawals, or payments, resolve complaints or account discrepancies
- Answer questions in person or on telephone and refers customers to other bank services as necessary
- Contributes to team effort by accomplishing related results as needed
Education
Certificate Of Phlebotomy Technician -
Phlebotomy Training Specialist
Hapeville, GA09-2024
Medical Assistant -
Sanford Brown College
06.2016
Associate of Business Administration - Finance
Southern Crescent Technical College
Griffin, GA05-2012
HS Diploma -
Tri-Cities High School
05.2009
Skills
- Wonderful leadership Skills
- Good Communication Skills
- Ability to Multi-Task
- Great Writing Skills
- Great Organizational Skills
- Good Time Management Skills
- Efficient with Microsoft Office
- Excellent Problem Solving Skills
- HIPAA compliance
- Prior authorization processing
- Insurance verification
- Knowledgeable in (EPIC USER, AIDIN, PARACHUTE *DME)
Certification
- Completed my externship with Kids Pediatric in 2016 earning a certificate of completion
- Completed Phlebotomy Training Specialist 9/14/24 now certified Phlebotomist
Timeline
Case Management Authorization Specialist IP
Emory University Hospital Midtown
03.2025 - Current
Patient Access Associate / PRN
Piedmont Healthcare
03.2024 - Current
Patient Access Representative II
Emory Healthcare
12.2021 - 03.2025
Bank Teller
Wells Fargo
09.2018 - 12.2021
Certificate Of Phlebotomy Technician -
Phlebotomy Training Specialist
Medical Assistant -
Sanford Brown College
Associate of Business Administration - Finance
Southern Crescent Technical College
HS Diploma -
Tri-Cities High School
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