Karen Edwards
Boulder,CO
Summary
Reliable professional offering a twenty-year career promoting positive customer experiences, strong work ethics, exceptional interpersonal skills, and adept at working effectively unsupervised while quickly mastering new skills. Highly motivated, with a desire to take on new challenges in a fast-paced environment. Compassionate and respectful promoting issue resolution expertise and committed to delivering exceptional service and respect for all individuals and their privacy. Currently employed by Boulder Medical Center as a Patient Access Associate originally hired as a Medical Scheduler in April 2023 with focus on multiple specialty referral processing. The Foothills site transitioned to Patient Access Associate position and I am seeking transition to Referral Specialist position which is more suited to my employment history and initial hiring with Boulder Medical Center.
Overview
3
3
years of professional experience
Work History
Medical Scheduler
Boulder Medical Center
Boulder , CO
04.2023 - Current
- Scheduled patient appointments using electronic health record systems efficiently. Multi specialty clinic OBGYN, Endocrinology, ENT Pediatrics, Audiology and Urology
- Organized follow-up appointments based on physician recommendations.
- Assisted patients with insurance inquiries and eligibility verification processes.
- Maintained accurate records of patient information and scheduling changes promptly.
- Implemented best practices for appointment scheduling to enhance operational efficiency.
- Resolved scheduling conflicts by liaising with multiple departments seamlessly.
- Answered incoming calls from patients inquiring about their upcoming appointments or requesting changes to existing ones.
- Followed up with patients and confirmed appointments.
- Processed incoming referrals for new patients, verifying insurance information and scheduling appointments accordingly.
- Coordinated and scheduled complex procedures such as Confirmation of Pregnancy, In clinic ultrasound, procedures, tests, physicals and follow-up visits.
- Ensured compliance with facility policies and procedures related to patient scheduling.
- Processed patient referrals to specialists, coordinating appointments and information transfer.
- Ensured that all necessary documents were completed correctly prior to patient's appointment date.
- Assisted patients with canceling and rescheduling appointments.
- Prevented double bookings and set aside appropriate time in between appointments.
- Routed calls and correspondence to appropriate medical staff.
- Reviewed insurance information with patients and processed copays.
- Provided support to physicians in the form of appointment scheduling, answering phones, verifying insurance coverage and handling other administrative duties as needed.
- Managed all aspects of patient scheduling including cancellations and rescheduling requests due to illness or emergency situations.
Eligibility Analyst
Boulder County Housing and Human Services
Boulder, CO
10.2013 - 12.2019
- Handled inbound phone calls and answered customer inquiries.
- Completed required investigations on referred files within established timeframes.
- Performed research and due diligence to resolve issues.
- Checked claims for errors, corrected issues and mailed out updated documents.
- Entered client information and files into databases for further review and tracking.
- Explained reasons behind application denials and recommended further action.
- Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.
- Participated in continuing education, quality assurance and performance improvement activities.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Responded to client inquiries and concerns and escalated complex problems to department supervisors.
- Coordinated with other departments to promote prompt processing of client applications.
- Gathered financial information from clients regarding income, assets and debts.
- Reviewed applications to verify client information and resolve discrepancies.
- Managed intake of new claims and performed routine follow-ups.
- Processed benefits applications and documents for food stamps and medical assistance.
- Conducted interviews with applicants, explaining benefits process and which programs were available.
- Participated in new hire training and development tasks.
- Developed thorough knowledge of financial aid programs to recommend relief options matching client needs.
- Contacted client references and employers to determine legitimacy of applicant information.
Child Support Enforcement Specialist
Davidson County Department of Social Services
Lexington, NC
10.2005 - 06.2012
- Addressed legal issues, assisting with hearings and providing testimony to inform custody arrangements
- Assessed child support cases to determine appropriate case action.
- Executed appropriate case action to locate absent parents.
- Negotiated settlements and agreements with parties outside of court.
- Prepared forms and reports indicating current case statuses and schedules.
- Collaborated with social agencies in support of children due child support.
- Coordinated tests and paperwork to establish paternity, child support requirements and medical support obligations.
- Gathered information from custodial parents and documented case history in case management software.
- Monitored cases and reviewed to determine eligibility for closure.
- Reviewed applications for service and effectively interviewed custodial and non-custodial parents.
- Reviewed and maintained child support files and databases.
- Conducted detailed investigations to locate individuals, verify employment and determine assets.
- Maintained current knowledge of child support policies and procedures, North Carolina family law and federal regulations.
- Assisted prosecuting attorney with collection of necessary data in preparation for cases.
- Verified and authenticated validity and admissibility of evidence, preserving integrity for court hearings.
- Prepared documentation of administrative and legal actions related to child support orders.
- Maintained confidentiality through stringent handling of charts and data.
- Used job-related software to compose or prepare correspondence, case notes and technical reports
- Interviewed clients individually and in groups to assess situations, capabilities and problems.
- Participated in ongoing training to maintain license and enhance knowledge of relevant mental health topics.
- Collaborated with state agencies and benefits coordinators to develop individualized plans for each case.
- Interfaced with local court system, attending court proceedings and working directly with attorneys.
Medical Eligibility Specialist
Riverside County Department of Social Services
Riverside, CA
10.2000 - 06.2005
- Performed research and due diligence to resolve issues.
- Checked claims for errors, corrected issues and mailed out updated documents.
- Handled inbound phone calls and answered customer inquiries.
- Participated in continuing education, quality assurance and performance improvement activities.
- Completed required investigations on referred files within established timeframes.
- Entered client information and files into databases for further review and tracking.
- Explained reasons behind application denials and recommended further action.
- Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Responded to client inquiries and concerns and escalated complex problems to department supervisors.
- Coordinated with other departments to promote prompt processing of client applications.
- Gathered financial information from clients regarding income, assets and debts.
- Reviewed applications to verify client information and resolve discrepancies.
- Managed intake of new claims and performed routine follow-ups.
- Processed benefits applications and documents for food stamps and medical assistance.
- Conducted interviews with applicants, explaining benefits process and which programs were available.
- Participated in new hire training and development tasks.
- Developed thorough knowledge of financial aid programs to recommend relief options matching client needs.
- Contacted client references and employers to determine legitimacy of applicant information.
Skills
- Application Assessment
- Telephone Etiquette
- Advocacy and Counseling
- Applicant Support and Service
- Recordkeeping and Data Input
- Program Understanding and Advisement
- People Skills
- Data Management
- Conflict Resolution
- Problem Resolution
- Active Listening
- Reliable & Trustworthy
- Good Work Ethic
- Customer Service
- Friendly, Positive Attitude
- Organizational Skills
- Computer Skills
- Critical Thinking
Timeline
Medical Scheduler
Boulder Medical Center
04.2023 - Current
Eligibility Analyst
Boulder County Housing and Human Services
10.2013 - 12.2019
Child Support Enforcement Specialist
Davidson County Department of Social Services
10.2005 - 06.2012
Medical Eligibility Specialist
Riverside County Department of Social Services
10.2000 - 06.2005