Kcira Smith
Douglasville,GA
Summary
EMR EPIC Expert Willing to relocate: Anywhere Authorized to work in the US for any employer
Overview
11
11
years of professional experience
Work History
PAS Virtual & On-site
Wellstar-Douglassville, PA
Douglasville
12.2023 - Current
- Prior to a patients first visit, verify insurance coverage and benefits including co-payments and deductibles and OOP Max
- Verify insurance coverage and benefits on a daily basis through Recipient Eligibility Verifications Systems and various payor websites and/or via telephone
- Assist in Prior Authorizations, verify the accuracy of demographic and payor information
- Notify admissions, scheduling and other related departments regarding concerns and corrections
- Works in conjunction with Prior Authorization specialist to obtain initial and ongoing authorizations for outpatient visits, maintain tracking system, notify providers when continued authorizations are due and reapply as required
- Follow up with insurance carriers to make sure that authorizations have been completed
- Receive Explanation of Benefits and Authorizations and enter into the system as required
- Keep current on new policies and procedures of third-party payors, hospital procedures and any insurance updates in order to educate providers and staff
- Comply with departmental and organizational policies/procedures including but not limited to, dress code, telephones, cell phones, and computers
- Perform other work-related duties as requested/directed by management
- Observes work hours and provides proper notice of absences, tardiness work schedule changes
- Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the public
- Demonstrates ability to tactfully handle difficult situations
- Presents a well-groomed and professional image
- Attends select departmental meetings at the request of WHS Management
- Performs other duties as assigned
- May work in the work queues to resolve insurance verification or co
Front Office Receptionist
Wellstar Health System-Marietta, GA
Marietta
06.2021 - Current
- The Front Office Lead has the overall responsibility for ensuring a smooth patient flow in all daily front office operations, which may include: obtaining correct registration information, optimizing front office collections, scheduling appointments accurately and timely, managing medical records and referrals, and appropriate staffing for department
- Acts as the liaison, communicating between management and the office staff
- Acts as the liaison ,communicating between management and the office staff
Medical Front Office Receptionist/Surgery Scheduler
Norton Leatherman Spine Center-Louisville, KY
Louisville
02.2020 - Current
- Being a liaison between the physician and patient
- Responsible for answering the telephone, determining the nature of patient calls and incoming calls, scheduling appointments, routing calls, taking appropriate messages, pulling charts for messages, greeting patients and family members, obtaining registration and insurance data and updating information in the billing system, and facilitating patient flow into the practice
- Responsible for charge entry, referrals and pre-certifications, as well as scheduling of specialist appointments and diagnostic tests
- Attend to patients utilizing the age appropriate principles of growth and development for patients of all ages according to the practice specialty.
Supervisor
Security First-Louisville, KY
Louisville
04.2017 - 12.2019
- Insured the safety and security of Norton Healthcare properties, patients, employees, and visitors
- Independently or collaboratively as determined by Director and executive leadership: Monitors compliance with Norton Healthcare policies as well as accreditation and regulatory agency statutes/procedures which pertain to security
- Ensures all organizational goals, standards, and expectations are met and exercises appropriate decision making while serving as the facility representative to external agencies in security matters
- Dispatching security officers to multiple norton locations
- Create scheduling
- Assist in the hiring / on boarding process.
Medicare Specialist / Dental Enrollment
HUMANA-Louisville, KY
Louisville
01.2015 - 03.2017
- 1
- Initiate medical authorizations for providers on patient DME, surgery, shots, RX tier 4 drugs 2
- Override/ review RX claims3
- Contact providers to discuss billing 4
- Notify any balance billing on patient accounts. 5
- Schedule appointments 6
- Take patient payments 7
- Cpt auth checks 8
- Set up patient RX mail order. 9
- Settle patient account balance 10
- Handle medical claims (stop/ reissue checks to providers) 11
- Manage grievance and appeals 12
- Enrollment / disenrollment
Front Desk Receptionist
Jersey Shore University Medical Center-Neptune City, NJ
Neptune City
07.2013 - 04.2015
- Ensures smooth operation of the front desk, including scheduling appointments, patient reception, patient check-in, handling of cash receipts, processing mail and telephone reception.
- Work closely with the medical staff to ensure smooth operation of the clinical area, including patient flow and processing of medical records.
- Checks in patients, verifies and updates necessary information to support accurate registration.
- Files and coordinates lab work, physician reports to patient charts.
- Conveys an impression reflecting favorably on the Practice.
- Uses and maintains office equipment and has the ability to follow proper procedure for repairs and services.
- Identifies coding changes, insurance comments and precertification while implementing these changes with the practice.
- Maintain confidentiality of information regardless of source/medium.
- Electronically files and coordinates patient referrals and medical records to patient charts
- Understands insurance verification and precertification.
- Complies with all policies and procedures
- Organizes and manages time wisely
- Ability to sit for extended period
- Strong customer service skills
Education
Associate of Science in Criminal Justice - Criminal Justice
Ocean County College
Toms River, NJ06.2014
High School Diploma -
Toms River High School East
Toms River, NJ06.2013
Skills
- Epic Efficient
- Customer support
- Management sales
- Clerical
- Typing
- Problem solving
- Marketing
- Systems analysis
- CPT Coding
- Medical Billing
- EMR Systems
- Epic
Personal Information
Title: Management
Timeline
PAS Virtual & On-site
Wellstar-Douglassville, PA
12.2023 - Current
Front Office Receptionist
Wellstar Health System-Marietta, GA
06.2021 - Current
Medical Front Office Receptionist/Surgery Scheduler
Norton Leatherman Spine Center-Louisville, KY
02.2020 - Current
Supervisor
Security First-Louisville, KY
04.2017 - 12.2019
Medicare Specialist / Dental Enrollment
HUMANA-Louisville, KY
01.2015 - 03.2017
Front Desk Receptionist
Jersey Shore University Medical Center-Neptune City, NJ
07.2013 - 04.2015
Associate of Science in Criminal Justice - Criminal Justice
Ocean County College
High School Diploma -
Toms River High School East
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