Keitoria Madison
Glenn Heights,TX
Summary
Compassionate Patient Access Representative well-versed in performing diverse administrative functions for patient care with high degree of diplomacy and problem-solving acumen. Positive and upbeat team player with good communication and time management abilities. Demonstrated extreme attention to detail with accuracy of medical records.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Client Service Specialist I
Aetna, a CVS Health
Dallas, TX
08.2024 - 02.2025
- Coordinated the intake process, ensuring all required documentation was collected and processed.
- Maintained confidentiality of all patient information at all times.
- Conducted initial risk assessments to identify any immediate concerns or needs for intervention.
- Conducted initial intake interview to obtain client information, including biographical data, medical history, presenting problem, legal status, and other pertinent information.
- Participated in ongoing training and professional development related to intake procedures and client care.
- Verified insurance eligibility, benefits, and patient liabilities for defined services.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Maintained accurate records and documented client data in company databases.
- Maintained accurate records of all client interactions according to agency policies and procedures.
Insurance Verification Specialist
Medical Practice Solutions
Richardson, Texas
09.2019 - 12.2023
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Evaluated policies and procedures related to Insurance Verification activities.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Completed relevant insurance and other claim forms.
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
Insurance Verification Specialist
Texas Digestive Disease Consultants
Dallas, TX
05.2015 - 01.2019
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
- Utilized electronic medical records (EMR) systems for documenting verification processes.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Updated patient accounts with insurance verification information to ensure accurate billing.
- Responded to patient inquiries regarding insurance coverage and billing issues.
- Maintained up-to-date knowledge of insurance policies, including Medicare and Medicaid.
Patient Account Representative
Conifer Healthcare Solutions
Frisco, Texas
02.2012 - 10.2015
- Perform regular maintenance on coiling equipment to ensure proper operation.
- Maintain accurate records of production data such as number of coils produced per hour, day, week, month.
- Adjust machines according to specifications or tolerance requirements.
- Troubleshoot mechanical issues with the coiler and make necessary repairs or adjustments.
- Wrote appeal letters to insurance companies for denial of claims.
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Maintained organized filing systems for customer documents and records related to insurance policies.
- Followed up with delinquent accounts to collect past due payments via phone or mail correspondence.
- Accepted and processed customer payments and applied toward account balances.
- Received and responded to customer inquiries regarding insurance policies.
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
Patient Account Representative
Methodist Medical Center
Plano, Texas
07.2010 - 11.2012
- Maintained updated knowledge through continuing education and advanced training.
- Displayed strong telephone etiquette, effectively handling difficult
- Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
- Wrote appeal letters to insurance companies for denial of claims.
- Updated existing patient files with relevant information such as changes in address or contact information.
- Worked closely with insurance companies to obtain authorization for services rendered.
- Reviewed flagged items daily and resolved issues.
- Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
- Contacted customers with delinquent accounts to solicit payment.
- Assisted customers with enrollment into new coverage plans and answered policy-related questions.
- Received payments and posted amounts to customer accounts.
- Answered customer questions regarding account discrepancies or problems.
- Utilized various software programs such as Excel, Word, Access and QuickBooks when completing tasks.
- Reviewed claims for coding accuracy.
- Communicated regularly with team members about changes made in the collection process or procedures.
- Identified errors in data entry that impacted billing accuracy, corrected mistakes accordingly.
- Monitored incoming calls from customers seeking assistance with their insurance payments or policies.
Education
Associates - Medical Insurance Billing & Coding
Everest College
01.2009
Skills
- Insurance Verification
- Medical Insurance
- ICD-9
- Medical Terminology
- Microsoft Office
- Customer support
- Analysis skills
- ICD-10
- Medical Records
- Accounts Receivable
- Epic
- QuickBooks
- Anatomy Knowledge
- Medical Receptionist
- Clerical Experience
- HIPAA
- Workers' Compensation
- Word Processing
- Phone Etiquette
- Medical Imaging
- Auditing
- Software deployment
- SSO
- Data Entry
- Medical Office Experience
- Physiology Knowledge
- Typing
- Microsoft Access
- Windows
- Cold calling
- Computer hardware
- Databases
- Smartsheet
- Quality Assurance
Certification
Medical Billing & Coding Certification
Personal Information
Title: Insurance Verification Support Specialist/ Patient Account Representative
Timeline
Client Service Specialist I
Aetna, a CVS Health
08.2024 - 02.2025
Insurance Verification Specialist
Medical Practice Solutions
09.2019 - 12.2023
Insurance Verification Specialist
Texas Digestive Disease Consultants
05.2015 - 01.2019
Patient Account Representative
Conifer Healthcare Solutions
02.2012 - 10.2015
Patient Account Representative
Methodist Medical Center
07.2010 - 11.2012
Associates - Medical Insurance Billing & Coding
Everest College