Karen Schoon
Insurance Specialist
West Des Moines,IA
Summary
Organized and dedicated administrative professional with proven track record of providing exceptional team work in fast-paced environments. Offering keen attention to detail and strong decision-making skills to manage multiple, concurrent tasks. Self-motivated work ethic to perform effectively in independent or team environments.
Overview
31
31
years of professional experience
Work History
Insurance Verification Specialist
R1 RCM, Inc
11.2022 - Current
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Communicated verification and authorization status updates with Hospital admissions department to facilitate decision-making for patient admissions and insurance coverage.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Updated patient records with accurate, current insurance policy information.
- Complied with HIPAA guidelines and regulations for confidential patient data.
Revenue Cycle Representative
R1 RCM, Inc
12.2021 - 11.2022
- Correctly coded medical claims for various hospital facilities.
- Generated reports to identify coding trends and discrepancies.
- Followed up with medical staff regarding missing information in patient records.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
Hospital Associate
Pediatrix Medical Group Of Iowa NICU
07.2000 - 12.2021
- Collaborated with medical doctors and other healthcare professionals.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Trained new staff on current, correct insurance verification procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits and obtain authorization.
- Assisted with medical coding and billing tasks.
- Entered procedure codes and diagnosis codes into medical billing software.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Vermont Oxford Research: Gathered, arranged, and corrected research data to create representative graphs and charts highlighting results for presentations.
- Processed medical records requests, assuring release only to appropriate parties proper authorization.
- Improved office operations by implementing Out Of Network procedure, documents and patient education.
- Communicated effectively with staff members, physicians, and patients, employing active listening and interpersonal skills.
- Responsible for working correspondence on a daily basis.
- Completed administrative patient intakes, insurance information and mandated forms.
- Completed FMLA and other insurance paperwork for patients and families.
- Proved successful working within tight deadlines and a fast-paced environment.
- Successfully navigated building a professional relationship with hospital administrative, clinical and professional healthcare staff.
Medical Administrative Assistant
Des Moines Orthopaedic Surgeons
West Des Moines, IA
06.1997 - 07.2000
- Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
- Scheduled patient appointments and placed reminder calls to deliver exceptional customer experience.
- Coordinated with facilities to set up surgeries for multiple Orthopaedic Surgeons.
- Conducted insurance verification and preauthorizations and managed patient charts.
- Assisted with medical coding and billing tasks.
- Recorded information using word processing, dictation and transcription software and equipment.
- Assisted in maintenance of medical charts and/or electronic medical record filing, Op Reports, test results and home care forms.
- Followed all HIPAA rules and regulations regarding patient confidentiality.
- Called and faxed pharmacies to submit prescriptions and refills.
- Obtained client medical history, medication information, symptoms, and allergies.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
- Explained procedures to patients to reduce anxieties and increase patient cooperation.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Cultivated strong relationships with vendors and partners supporting administrative operations.
Medical Billing and Collections Specialist
Nebraska Orthopaedics and Sports Medicine
Lincoln, NE
01.1994 - 05.1997
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Reviewed provider coding information to report services and verify correctness.
- Followed up on denied claims to verify timely patient payment and resolution.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Researched and resolved complex medical claims issues to support timely processing.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Processed insurance payments and maintained accurate documentation of payments.
- Processed online and paper appeal submissions and refund requests.
- Assisted in reconciling deposit and patient collections.
- Processed billing calls and answered questions from patients and third-party carriers.
- Monitored outstanding invoices and performed collections duties.
- Utilized various software programs to process customer payments.
- Audited and corrected billing and posting documents for accuracy.
- Responsible for creating and submitting daily bank deposit
Emergency Room Technician
St. Elizabeth Medical Center
Lincoln, NE
04.1992 - 05.1997
- Assisted in obtaining and documenting vital signs and placement of oxygen saturation, cardiac monitoring, and non-invasive blood pressure monitoring systems.
- Received direction and assignments from physicians and nurses, providing efficient technical support to optimize patient care.
- Worked with nurses to assess patients and prepare for tests and procedures.
- Followed all hospital policies and procedures and complied with local, state, and federal agency and accrediting body guidelines.
- Provided triage, first-aid and referral to outside medical providers during workplace injury or medical emergency.
- Facilitated transfer of patients throughout medical facility and between departments.
- Assisted in preparation and maintenance of patient charts, documenting all care given.
- Liaised between nurses, physicians, patients and visitors.
- Supported patients and family members, actively listening to concerns and offering compassionate care.
- Catalogued patient data in clinical databases and registries according to regulatory practices.
Education
EMT - Emergency Medical Technology
Eastern Ambulance Services
Lincoln, NE 01.1992 - 04.1992
No Degree - Nursing
University of Nebraska - Lincoln
Lincoln, NEHigh School Diploma -
Bishop Neumann High School
Wahoo, NE05.1988
Skills
- Proficiency in Excel, Word, Outlook and other Windows products
- Strong Organization and Time Management Skills
- Effective Written and Verbal Communication Skills
- Adaptable and Flexible
- Able to Manage Multiple Tasks
- Highly Self-Motivated With Keen Attention to Detail
- Data Abstractor
- Medical and Insurance Billing Experience
- Knowledge of insurance Carrier Policies and Practices
- Knowledge of Medical Terminology
- Analytical and Problem-Solving Skills
- Knowledge of Procedure and Diagnosis Coding
References
References available upon request.
Timeline
Insurance Verification Specialist
R1 RCM, Inc
11.2022 - Current
Revenue Cycle Representative
R1 RCM, Inc
12.2021 - 11.2022
Hospital Associate
Pediatrix Medical Group Of Iowa NICU
07.2000 - 12.2021
Medical Administrative Assistant
Des Moines Orthopaedic Surgeons
06.1997 - 07.2000
Medical Billing and Collections Specialist
Nebraska Orthopaedics and Sports Medicine
01.1994 - 05.1997
Emergency Room Technician
St. Elizabeth Medical Center
04.1992 - 05.1997
EMT - Emergency Medical Technology
Eastern Ambulance Services
01.1992 - 04.1992
No Degree - Nursing
University of Nebraska - Lincoln
High School Diploma -
Bishop Neumann High School
Similar Profiles
SUSANNE MCDONOUGHSUSANNE MCDONOUGH
Patient Access Supervisor at R1 RCM, IncPatient Access Supervisor at R1 RCM, Inc
Mahek BaigMahek Baig
AR Specialist at R1 RCMAR Specialist at R1 RCM
Syed Shaheen ParveenSyed Shaheen Parveen
Senior Analyst at R1 RCMSenior Analyst at R1 RCM
Braydon VanderpoolBraydon Vanderpool
Rigger/ Operator at Bailey Roofing Contractors INC.Rigger/ Operator at Bailey Roofing Contractors INC.
La-Tica PaigeLa-Tica Paige
Executive Assistant to the President & CEO at Lutheran Services in IowaExecutive Assistant to the President & CEO at Lutheran Services in Iowa