Joelle Clingerman
Gardiner,ME
Summary
Patient Service Specialist with expertise in healthcare administration, patient relations, and appointment scheduling. Strong communication skills, proficiency in electronic health record systems, and ability to multitask efficiently. Proven track record of enhancing patient satisfaction and optimizing office workflow.
Overview
7
7
years of professional experience
Work History
Patient Service Specialist
Saco Bay Physical Therapy
Hallowell And Saco, ME
08.2022 - Current
- Greeted patients upon arrival and verified patient information.
- Provided assistance with completing paperwork, such as insurance forms and medical history.
- Scheduled appointments and managed patient records using electronic health record software.
- Contributed to team meetings, sharing insights and strategies for improving patient access services.
- Processed patient co-pays, deductibles, and other payments, ensuring accurate financial records.
- Performed administrative tasks such as filing, faxing documents, copying materials, and other clerical duties as needed.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated financial obligations to patients and collected fees at time of service.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Collaborated with insurance companies to resolve billing discrepancies and pre-certification issues.
Provider Services Specialist
Anthem Blue Cross Blue Shield
South Portland, ME
10.2017 - 07.2022
- Utilized multiple software applications for claims processing, tracking, analysis.
- Processed provider claims, verifying billing information for accuracy.
- Provided customer service to clients, including answering phone calls and emails in a timely manner.
- Reviewed medical records for coding accuracy according to established guidelines.
- Identified areas of potential fraud or abuse related to provider services activities.
- Investigated appeals from providers regarding payment denials or underpayments.
- Evaluated current processes within the department to identify areas of improvement.
- Ensured that all requests from providers were handled in compliance with relevant regulations.
- Trained other staff members on new systems or changes in existing processes.
- Collaborated with internal teams such as finance and legal departments when needed.
- Researched customer issues to understand problems and developed successful resolutions.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Education
Bachelor of Arts - Theatre Arts
University of Southern Maine
Gorham, ME05-2009
Skills
- Policy Verification Process
- Coordinated Scheduling Expertise
- HIPAA Compliance
- Strong Organizational Skills
- In-Depth Insurance Knowledge
- Professional Communication Skills
- Medical Terminology
- Payment Processing
- Collaborative Team Management
References
References available upon request.
Timeline
Patient Service Specialist
Saco Bay Physical Therapy
08.2022 - Current
Provider Services Specialist
Anthem Blue Cross Blue Shield
10.2017 - 07.2022
Bachelor of Arts - Theatre Arts
University of Southern Maine