Results-driven benefits specialist with expertise in navigating complex verification processes. Strong analytical skills and in-depth knowledge of insurance protocols ensure accurate and timely benefit resolutions. Known for effective collaboration, adaptability, and steadfast commitment to achieving team goals. Highly reliable, with focus on precision and compliance in all tasks.
Overview
24
24
years of professional experience
Work History
Benefits Verification Specialist / Program Coordinator II-PSR
11.2019 - Current
The Benefits Verification Specialist will ask appropriate questions regarding a patient's benefits and complete data entry and/or appropriate forms to document patient benefits coverage. The Program Coordinator assesses and identifies missing information on behalf of medical documentation and records. The Program Coordinator coordinates all activities required to answer, solve, or alleviate client concerns for the program in a quick, efficient, and professional manner.
As a Benefits Verification Specialist, a typical day might include the following: Verifying patient insurance benefit information
Triages cases with missing information to appropriate program associate. Verifies patient specific benefits and precise documents specifics for various payer plans including patient coverage, cost share, and access/provider options.
Processing Enrollment forms for patients, Reporting Adverse Events to Sanofi, update Med D forms for existing patients for renewal medications, update any missing information, add providers to new or existing patient accounts
Data entry, maintain many reports for corrections, check for errors in name or providers.
Handles faxes (incoming/outgoing) accordingly and timely.
Performs general administrative tasks such as typing and maintenance of filling systems for the program.
Serves as a liaison between other members of the team.
Reviews and analyzes documents for Adverse Events.
Reports Adverse Events.
Audits and maintains various reports specific to his/her business location by checking for errors, inconsistencies, or discrepancies; makes corrections and notifies appropriate personnel of any modifications.
SR Financial Collection Representative
GM Motors Financial
09.2012 - 11.2019
Receiving and processing information received from dealership
Processing information in contacting customers for payments
Process new car loans for approval or denial
Assist with high priority accounts
Strong analytical and problem-solving skills with the focus on root cause analysis
Processed payments and contracts on accounts.
Counseled debtors on payment options and arranged installment agreements.
Used skip tracing resources to locate debtors and updated information in company system.
Negotiated to collect balance in full.
Handled highly sensitive information responsibly while maintaining strict confidentiality standards.
SR Human Resource Administrative Assistant II
Accretive Commerce
08.2007 - 03.2010
Managed and maintain important documentation
Worked and greeted customers in obtaining general information
Assisted with faxing, and making copies for different departments
Trained new hires for the company
Worked on multiple telephone lines and routed to appropriate associates to complete the call to customers satisfaction.
Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
Assisted in onboarding new employees, providing training materials, and coordinating orientation schedules to ensure a smooth integration into the team.
Implemented new CRM system to track client interactions, improving response times and client satisfaction.
Managed complex HR projects, leading to increased organizational effectiveness and collaboration.
Medical Record Clerk/Patient Access Specialist
Moses Cone Health Services
06.2004 - 07.2007
Assisted in retrieving charts and creating new charts for new clients for accuracy
Retrieving client’s chart by using proper procedure in signing out chart and signing back in when chart has been received back in appropriate file cabinet
Retrieved patient’s records to appropriate department within the hospital
Maintain the confidentiality of client’s information by following the procedure, getting charts to appropriate departments while keeping the client’s information private
Utilized strong multitasking skills to manage multiple priorities and tasks, ensuring timely completion of each assignment.
Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
Maintained patient confidentiality by adhering to HIPAA guidelines and hospital policies.
Provided exceptional customer service, addressing patient concerns promptly and professionally.
Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
Handled sensitive situations involving distressed patients with empathy maintaining professionalism throughout interactions.
Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
Medical Coding and Billing Specialist
Dr Paul Pritchett Office
02.2002 - 11.2004
Assisted with collecting past due accounts and establishing payments to bring account current
Worked in the collection department in collecting past due accounts by court procedures.
Spokesmen for hospital in small claims court in collecting past due accounts
Serve and protect the hospital community by adhering to professional standards
Follow hospital policies and procedures for federal and state requirements to ensure all rights or protection.
Practice and protected all client’s HIPPA rights and ensure rights have not been violated.
Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
Provided exceptional customer service to patients, addressing their concerns regarding insurance claims or billing issues with empathy and professionalism.
Maintained patient confidentiality by adhering to strict HIPAA regulations during all aspects of the coding and billing processes.
Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Education
Associate Degree - Business Administration And Management
Strayer University
Charlotte, NC
01.2014
Diploma Degree - General Studies
Martinsville senior High
Martinsville, VA
06.2001
Skills
Accuracy and precision
Healthcare regulations
Policy interpretation
Verbal and written communication
Written and oral communication
FMLA comprehension
Benefits administration
Payroll coordination
Human resources management
Problem-solving
Time management
Teamwork and collaboration
Training
Knowledge of ICD-09-ICD-10
As-400
Medical Terminology
Microsoft word 10
Word
Excel
PowerPoint
IDX system
Timeline
Benefits Verification Specialist / Program Coordinator II-PSR
11.2019 - Current
SR Financial Collection Representative
GM Motors Financial
09.2012 - 11.2019
SR Human Resource Administrative Assistant II
Accretive Commerce
08.2007 - 03.2010
Medical Record Clerk/Patient Access Specialist
Moses Cone Health Services
06.2004 - 07.2007
Medical Coding and Billing Specialist
Dr Paul Pritchett Office
02.2002 - 11.2004
Diploma Degree - General Studies
Martinsville senior High
Associate Degree - Business Administration And Management