Jeannine Ann Schueller
Summerville,SC
Summary
Results-driven Advanced Medical Support Assistant with extensive experience in patient care and healthcare administration. Proficient in navigating insurance processes, medical terminology, and billing systems, contributing to streamlined operations and exceptional patient satisfaction. Demonstrates strong communication skills and the ability to multitask effectively, ensuring high-quality service delivery under pressure. Committed to enhancing office efficiency and supporting team goals within a dynamic healthcare environment.
Overview
27
27
years of professional experience
Work History
Advanced Medical Support Assistant
Knoxville CBOC Morristown CBOC
Morristown, TN
10.2021 - Current
- Works with PCMM consisting of 4 PACT teams, Pharmacy, Social Work, Telehealth and specialty clinics
- Ensures that clinic is managed for maximum clinic utilization, adjusting as needed on a daily basis depending on clinic schedules
- Attends team huddles daily for updates on clinic needs, monthly staff meetings and responses from outside vendors such as Non-VA correspondence regarding veteran appointments
- Update veteran demographics at every appointment and update ICB for insurance
- Schedule appointments, review consults, respond to veteran appointment request via VAR and NEAR
- Daily review of return to clinic requests and schedule appropriately
- Works independently with minimal supervision, handles clinic cancellations based on knowledge of standard operating procedures and PACT team preferences
Care Coordinator
Author By Humana
Charleston, SC
08.2020 - Current
- Non-clinical support to members, assessing their needs to ensure they maintain optimal wellness
- Assists members with understanding claims, files grievances and appeals on their behalf
- Begins prior authorizations for medications, reviews authorizations for members
- Assists members with ordering OTC medications, refills medications for members
- Attends training as needed
- Verifies eligibility to physician office as needed as courtesy to member
Advanced Medical Support Assistant
James H Quillen VAMC
01.2024 - 12.2024
- Works collaboratively in an interdisciplinary coordinated care delivery environment in outpatient specialty clinics-Neurosurgery, Vascular Surgery, General Surgery, Colorectal Surgery, Thoracic Surgery and Wound Care
- Coordinates with the patient care team to review the clinic utilization by using various reports such as Excel Spreadsheets to track return to clinics, clinic grids and provider LEAF requests
- Ensure that the clinic setup is closely monitored to effectively support the needs of the clinic, and make any necessary adjustments based on clinic staffing, and patient needs
- Develop/maintain effective and efficient communication with the patient, interdisciplinary team, management team, VA medical centers, and other agencies via Teams, staff meetings and face to face interactions
- Collect, scans, and updates health insurance information, promote Veteran registration and utilization of My HealthyVet (MHV) by reviewing patient demographics, ICB buffer, medical records from private institutions
- Train other MSAs on current, up to date clinic operations
- Schedule appointments: notifies lead or supervisor and provider if an individual patient cannot be scheduled within mandated timeframes
- Daily review of active/pending Recall list and pending radiology orders for accuracy and disposition
- Organizes work independently and handles scheduling problems and deviations based on personal knowledge of clinic operations and policy, schedules, and provider's preferences
Patient Support Assistant
James H Quillen VAMC
09.2023 - 01.2024
- Processes 10-10 EZ, 10-10EZR applications and determines eligibility for outpatient treatment, travel reimbursement, enrollment applications and updating financial information
- Receives and enters enrollment applications from sources such as Internet, interviews, and walk-in patients
- Answers calls from veterans, healthcare associates and community daily and makes every effort to provide resolution of needs
- Researches and utilizes various directives such as ES, VIS, or VBMS to make eligibility determinations
- Compiles and provides information such as number of patients enrolled in specific clinics
- Reviews and reports any record discrepancy to the attention of the supervisor
- Screens a variety of requests and provides information as necessary, such as requests for service/non-service-connected follow-up examinations from other facilities, transfer of veterans from one facility to our facility, assist traveling veterans with registration, HUD VASH applications and Grant Per Diem
- Provide information to patients and family members regarding access to care
- Maintains consistent professional relationships with supervisors, coworkers, and/or subordinates
- Completes the preregistration process on each patient
- Reviews and updates demographic, financial, and insurance information in the patient's file
Advanced Medical Support Assistant
Salt Lake City VAMC CITC
01.2023 - 09.2023
- Reviews patients records and physicians' orders on a variety of records; and selects, completes, and routes requests for patient activities and treatment procedures
- Uses computers to perform communication via email, teams messaging (video and audio), and maintaining records and authorization in spreadsheets and other databases
- Receives and relays incoming and outgoing telephone calls; directs patient and provider offices regarding consults and authorization status
- Maintains effective and efficient communication with the patient, care team, VA medical centers, and community care providers
- Adheres to all organizational and departmental policies, directives; and standards pertaining to all job function's, with priority to the universal scheduling process, the electronic wait lists and the recall system, pre-registration updates, check-in, check-out, clinic 'clean-up', patient confidentiality and privacy laws, business office policies and insurance capture
- Remote
Authorization Supervisor
Change Healthcare
Charleston, SC
03.2020 - 06.2020
- Authorization Supervisor for Mayo Clinic laboratory accounts that was to go live 10/2020
- Collaborated designing a model to bring various insurance groups into a system for authorization
- Job was dissolved due to Covid
Administrative Assistant/LPN
Medical University of South Carolina
Charleston, SC
09.2018 - 01.2020
- Answering phones, scheduling appointments, checking in patients (including reviewing EMR prior to visit for completeness-immunization requirements, insurance verification and enrollment status), printing labels and organizing daily appointment sheets, sending appointment reminders
- Filing insurance using ledger billing, taking payments, processing medical record requests (sending and receiving), using computer applications (including EMR), scanning and faxing, and maintaining forms inventory
- Provide medical assistance support to medical staff by performing medical procedures such as taking vital signs and initial medical histories, drawing blood, removing sutures, changing dressings, administering and reading TB tests, taking electrocardiograms and performing basic laboratory tests
- Ongoing staff education for insurance referrals and insurance changes
- Update denial list weekly from BCBS from spreadsheet
- Ordering medications for clinic and maintaining stock of supplies
- Meeting with pharmacy monthly for inspection of stock
- Serves as timekeeper for Student Health
Case Manager/Prior Authorization
Charleston Cancer Center
Charleston, SC
03.2018 - 08.2018
- Obtains authorization for all radiology studies, chemotherapy and outpatient specialty referrals
- Verify eligibility and benefits for Medicare, Medicaid and private insurances
- Act as financial counselor for Center in securing payment for procedures, placing patients in payment plans and collection of debt
- Manage spreadsheet of authorized procedures both in clinic and outpatient
- Training of staff in authorization process
- Scheduling Peer to Peer insurance reviews, Utilization Management of retro authorization of denials
- Maintain close contact with providers and nurses to update insurance authorizations and denials
- Ongoing education of staff for updated insurance requirements for procedures (Medicare LCD/NCD guidelines, insurance changes to CPT codes)
Oncology Financial Coordinator (Bone Marrow Transplant)
Medical University of South Carolina
Charleston, SC
09.2015 - 07.2017
- Managed all bone marrow transplants from the initial clinic visit through post-transplant follow-up
- Create and organize a bone marrow transplant package on each patient for the physicians, nurses, and third-party payers
- Review clinical information to ensure patients have scheduled and completed all requirements prior to the transplant event
- Create and present a presentation with updates for each transplant case
- Develop and present a presentation each week to discuss individual cases, cumulative transplant volumes, payer mix, and other discussion points in front of transplant nurses, physicians, and departmental leaders
- Prepare billing sheets and invoices
- Enter charges with revenue codes and HCPCS codes into Epic
LPN
Ralph H Johnson VAMC
Charleston, SC
04.2015 - 08.2015
- Provided nursing care in the outpatient specialty clinics
- Recorded patients’ medical history, vital statistics, and test results in medical records
- Delivered high-quality and compassionate treatment to the Veteran community
- Independent decision-making ability consistent with medical protocols
- Provided health education for patients
- Performed all tasks with a patient-centered focus
Facility Revenue Technician
Veterans Affairs/Midsouth CPAC Services
Johnson City, TN
01.2010 - 04.2015
- Determine eligibility and processed 1st party and 3rd party claims
- Responsible for customer service when veterans have a question regarding billing of 1st party and 3rd party claims, as well as ensuring that service-connected veterans receive their care at no cost to them
- Processed Subrogation and Workman’s compensation claims
- Created reports to ensure that the VA recovered insurance payments for 3rd party insurance
- Accurately entered procedure codes, diagnosis codes, and patient information into billing software
- Liaison between the business departments, billers, and third-party payers in resolving billing and reimbursement issues
Fee Services Clerk
James H Quillen VAMC
Johnson City, TN
07.2009 - 12.2009
- Scheduled clinical non-VA care consults to include pain management, oncology, radio nuclear studies, urology, nephrology, obstetrics, and gynecology
- Clinical review of the medical records to determine the need of a consult
- Scheduled a minimum of 40 to 60 consults a day
- Responsible in contacting the veteran to arrange travel arrangements or travel pay
- Proficient in processing payments of claims in all specialties
Program Support Clerk
James H Quillen VAMC
Johnson City, TN
01.2008 - 06.2009
- Processed 1st and 3rd party customer service requests, applications for waivers, and Tort claims
- Provided customer service for veterans and family members
- Champ VA and Tricare billing for the medical center which included prior authorizations for active-duty military personnel that presented to the VA
- Setup internal self-pay collection department
- Responsible for maintaining an entire hospital system charge master
LPN
James H Quillen VAMC
Johnson City, TN
06.2001 - 12.2007
- Recorded patients’ medical history, vital statistics, and test results in their medical record
- Coordinated care with physicians
- Prepared for HIPAA and JCAHO reviews, ensuring required HIPPA brochures and pamphlets were available to all patients
- Trained 10 staff nurses to provide high reliability care
LPN
Rural Health Consortium
Bluff City, TN
04.1998 - 04.2001
- Conducted medical screenings, diagnostic treatments, and rehabilitative services as the senior nurse in a primary healthcare team
- Disciplined and energetic employee who quickly establishes rapport with patients and colleagues
- Managed team of medical support personnel
- Assisted patients with multiple chronic diseases
- Responsible for primary care and medication management
Education
Practical Nursing Program -
Tennessee Technology Center
Elizabethton, TN12.1997
Skills
- Licensed Practical Nurse
- Appointment Coordination
- Pre-Approval Processes
- Claims Verification Expertise
- Financial Management Coordinator
- ICD10 coding
- HCPCS coding
- HIPAA Compliance
- EMR-EPIC
- Point and Click
- Healthcare Billing Competence
- UB04 claims
- HCFA 1500 claims
- Medical terminology
- Organizational skills
- Communication skills
- Patient communication
References
References available upon request.
Timeline
Advanced Medical Support Assistant
James H Quillen VAMC
01.2024 - 12.2024
Patient Support Assistant
James H Quillen VAMC
09.2023 - 01.2024
Advanced Medical Support Assistant
Salt Lake City VAMC CITC
01.2023 - 09.2023
Advanced Medical Support Assistant
Knoxville CBOC Morristown CBOC
10.2021 - Current
Care Coordinator
Author By Humana
08.2020 - Current
Authorization Supervisor
Change Healthcare
03.2020 - 06.2020
Administrative Assistant/LPN
Medical University of South Carolina
09.2018 - 01.2020
Case Manager/Prior Authorization
Charleston Cancer Center
03.2018 - 08.2018
Oncology Financial Coordinator (Bone Marrow Transplant)
Medical University of South Carolina
09.2015 - 07.2017
LPN
Ralph H Johnson VAMC
04.2015 - 08.2015
Facility Revenue Technician
Veterans Affairs/Midsouth CPAC Services
01.2010 - 04.2015
Fee Services Clerk
James H Quillen VAMC
07.2009 - 12.2009
Program Support Clerk
James H Quillen VAMC
01.2008 - 06.2009
LPN
James H Quillen VAMC
06.2001 - 12.2007
LPN
Rural Health Consortium
04.1998 - 04.2001
Practical Nursing Program -
Tennessee Technology Center
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