Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Jennifer Whaley

Pennsauken,NJ

Summary

Pragmatic Insurance Verification Specialist touting 10 years of healthcare expertise in benefits explanation, coverage tracking and authorizations, in addition to, other administrative support roles . A team player with a vast knowledge of medical terms and the ability to work with all types of personalities effectively. Offering dynamic organizational skills and attention to detail. Versatile professional serves as first point of contact for patients by verifying insurance, handling paperwork and preparing records. Patient-oriented and helpful candidate familiar with MS Office and EHR systems coupled with thorough knowledge of medical terminology. Committed to providing personalized service and quality patient care.

Overview

11
11
years of professional experience

Work History

Remote Precertification /Insurance Verification Specialist

Mid Atlantic Retina
02.2023 - Current
  • Provided timely notification of scheduled inpatient / outpatient admissions; utilize patient demographics verifying active coverage ensuring claims meet guidelines of insurance carriers' notification request.
  • Proficient use medical terminology; ICD-10, HCPCS, UB04, CMS 1500, CPT Coding •Follow scripted benefits verification/precertification format in Meditech benefits screen and record benefits and pre-certification information.
  • Assign I-Plans from insurance eligibility confirmation obtained for the pre-certification of admission, follow up and facility status changes.
  • Accurately inputted all patient and insurance information into company's computer system using Meditech.
  • Reviewed 440 patient admissions per week and verified insurance coverage information.
  • Admissions Follow up; track, update, and manage accounts; confirm provider and patient responsibility, monitor accounts in Meditech for claim discrepancies, non-payment, denials, appeals, collections, pre-authorization information.
  • Adhere to all policies/procedures; AIDET Policies Patient Interactions, Company Mission and Value Statements and Codes of Conduct providing highest level of quality care to patients.
  • Posted payments to accounts and maintained records.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Observed strict procedures to protect sensitive patient information, including medical records and payment data.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Trained new staff on current, correct insurance verification procedures.
  • Updated patient records with accurate, current insurance policy information.
  • Achieved insurance pre-authorizations to enable timely patient procedures.
  • Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
  • Complied with HIPAA guidelines and regulations for confidential patient data.
  • Completed administrative patient intakes with case histories, insurance information and mandated forms.
  • Conducted patient intake interviews, recording and documenting relevant information.
  • Managed office logistics by scheduling appointments, maintaining files and collecting payments.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.

Patient Care Liaison

Cooper University Hospital
06.2021 - 02.2023
  • Processed electronic claim submission of emergent/non-emergent EMS/Life Flight transports.
  • Managed patient accounts; assuring patient demographic, update medical records information provided by patients, healthcare and insurance providers.
  • Proficient use medical terminology; ICD-10, HCPCS, UB04, CMS 1500, CPT Coding, Verification, Eligibility, Coverage and Authorization of services; Medicare, Medicaid, Commercial/Private Payers, VA and Disability Adjudication.
  • Finance, Accounting and Billing duties; payables and receivables; receipts, checks, voucher preparation, credit cards payments, void transactions and reimbursements.
  • Reconciled invoices and reports confirming accurate processing of all claims, billing, payments and reimbursements.
  • General Office Duties: Copying, Electronic / Hard Copy Filing, Faxing, Scanning, Archiving, 10-Key, Data Entry, Mail, Notary, Order Supplies, Send/Receive Overnight Packages; FedEx, UPS and DHL.
  • Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
  • Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
  • Identified, researched and resolved billing variances to maintain system accuracy and currency.
  • Increased customer satisfaction by resolving account issues.
  • Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
  • Produced, distributed and tracked more than 150 monthly invoices for emergent/non-emergent transportation business.
  • Organized and distributed correspondence, memoranda and telephone messages.
  • Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.

Patient Care Technician

Lourdes Medical Center
05.2013 - 03.2021
  • Daily Maintenance and Operation of New / Preowned Vehicle Inventories; Incoming and Outgoing units for all Dealer Trades, Billing and Invoicing; Custom/Fleet ordered units.
  • Microsoft Office; Word / Excel for Accounting, Employee and Inventory Records.
  • Managed Dealer Vehicle Documentation; Tag / Title Applications, MSO Certificates.
  • General Office Duties: Copying, Electronic / Hard Copy Filing, Faxing, Scanning, Archiving, Operate Multi-Lined Switchboard, Mail, Notary, Order Supplies, Send/Receive Overnight Packages; FedEx, UPS and DHL.
  • Human Resources; maintain all employee records, schedules and meetings, Order Office Supplies, Dealer Forms / Company Letterhead, Vehicle Inventory Supplies.
  • Scanned all financial and accounting documents into a data archiving system to create a paperless method for filing and tracking all of the dealerships important records.
  • Accounting; Daily/Monthly Financial Expense; Receipts, Checks, EFT, Vouchers, Credit Cards, Reconciled Bank/Vendor Statements, Billing, Invoicing, General Ledgers, Reports, Collections.
  • Conferred with managers, sales teams and engineering personnel to revise plans and achieve demanding targets.
  • Completed [Timeframe] logs and reports detailing production data such as volume, materials used and quality assurance results, helping management make accurate operational decisions.
  • Implemented organizational systems to optimize product placement and operational productivity.
  • Recorded information, shortages and discrepancies to keep records current and accurate.
  • Accepted delivered packages, verified products and checked delivery totals to keep system records current and accurate.
  • Kept all documentation and records accurate and up-to-date with latest data to prevent errors in processing or delivery.
  • Audited and corrected discrepancies in inventory numbers.
  • Checked prices and calculated totals for accurate invoice processing.
  • Addressed internal supply problems head-on and developed creative solutions to prevent delays and missed targets.
  • Organized and replenished unit supplies to maintain team readiness for expected demands.
  • Responded to patient emergencies with immediate care and notified clinicians to provide comprehensive assistance.
  • Answered patient assistance calls, assessed needs, and offered qualified support.
  • Obtained patient vital signs and reported results to staff nurse or physician, noting changes from prior measurements.
  • Supported patient admissions, discharges, and transfers to promote team productivity.
  • Collected and transported specimens to prepare for lab testing.
  • Used principles of growth and development to provide age-specific treatment and care.
  • Documented patient information and care activities in electronic health record.
  • Provided care to patients throughout lifespan with consideration of aging processes, human development stages and culture.
  • Maintained patient stability by checking vital signs and weight and recording intake and outtake information.
  • Upheld infection control and prevention policies across different patient-facing areas.
  • Monitored patient specimen samples and test results to effectively alert supervisors of potentially unhealthy changes.

Education

Human Services - Social Psychology

Camden County College
Blackwood, NJ
01.2002

High School Diploma -

Pennsauken Igh School
Pennsauken, NJ
06.2001

Skills

Attention to Detail, Communication, Computer Skills, Numeracy – Accuracy, Organization - Decision Making and Soft Skills

Organizational; Delivering Mail, Efficient, Filing, Management, Multitasking, Oversight, Photocopying, Collating, Planning, Sorting, Time Management

Analytical, Making Travel Arrangements, Prioritization, Problem Solving, Reasoning, Record Keeping, Scheduling Appointments, Typing, Team building, Problem resolution

Data Entry, Data Management, Database Fluency, MS Office, Office Machines, Word Processing, Publishing

Customer service, Email, Faxing, Front desk, Language skills, Listening, Oral communication, Proofreading, Writing

Prior authorization processing

  • Coverage and Authorizations
  • Medicaid Knowledge
  • Data Security and Confidentiality
  • Insurance Coverage Verification
  • Prior Authorization Processing
  • Understanding of Medical Terms
  • Patient Contact
  • Customer Relationship Management
  • Medical Terminology
  • Communication and Interpersonal Skills
  • Proficient in Software
  • Customer Service
  • Analytical Thinking
  • Attention to Detail
  • Data Entry and Review
  • Skilled in Software
  • Documentation and Correspondence
  • Data Review
  • Data Verification
  • Account Maintenance
  • Work Monitoring
  • Patient Communication

Accomplishments

  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Supervised team of 5 staff members.

Timeline

Remote Precertification /Insurance Verification Specialist

Mid Atlantic Retina
02.2023 - Current

Patient Care Liaison

Cooper University Hospital
06.2021 - 02.2023

Patient Care Technician

Lourdes Medical Center
05.2013 - 03.2021

Human Services - Social Psychology

Camden County College

High School Diploma -

Pennsauken Igh School

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Jennifer Whaley