Summary
Overview
Work History
Education
Skills
Timeline
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Kelly Mckay

Vidor,Tx

Summary

Dynamic Precertification Specialist with Baptist Hospital of Southeast Texas Cancer Center, skilled in medical billing and effective communication. Successfully streamlined eligibility processes, enhancing client support and compliance. Proven ability to resolve discrepancies and build relationships with diverse stakeholders, ensuring optimal patient care and program implementation.

Overview

23
23
years of professional experience

Work History

Precertification Specialist

Baptist Hospital of Southeast Texas Cancer Center
01.2018 - 07.2025
  • Interviewed applicants and explained scope of different available benefits.
  • Reviewed applications for different aid programs and determined which qualification criteria for individuals.
  • Communicated with people from various cultures and backgrounds on application process.
  • Scheduled appointments with applicants to gather information and explain benefits processes.
  • Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
  • Resolved discrepancies with client applications to verify eligibility.
  • Engaged wider departments in accurate, timely paperwork completion.
  • Trained staff on current eligibility requirements and policies.
  • Established databases to track, analyze and automate eligibility application processes.
  • Assisted clients with accurate eligibility form, application and document completion.
  • Processed and certified documents for accuracy and compliance with government regulations.
  • Built relationships with diverse stakeholders to achieve successful program implementation.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
  • Assisted with medical coding and billing tasks.
  • Managed office bookkeeping with insurance billing and patient payments.
  • Prepared and processed patient referrals and transfer requests.
  • Completed administrative patient intakes with case histories, insurance information and mandated forms.
  • Processed medical insurance claims and payments.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.

Referral Coordinator

Joseph M. Finley M.D.
02.2006 - 01.2018
  • Weighed patient need, provider availability, and insurance coverage to determine optimal scheduling.
  • Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
  • Scheduled appointments with specialists on behalf of clients.
  • Called insurance companies to get precertification and other benefits information on behalf of patients.
  • Attended continuing education courses to stay current on referral processes and best practices.
  • Processed referral requests from patients, doctors and other health care professionals.
  • Developed and maintained strong working relationship with referral sources to streamline processing.
  • Assisted with completion of referral forms and verified data accuracy and completion
  • Facilitated referrals to other healthcare providers and resources to bridge service gaps.
  • Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
  • Scheduled surgeries, managed pre-certifications and verified insurance coverage.
  • Spearheaded and implemented new projects to expand scope of engagement.
  • Successfully negotiated client contract renewals to create increased revenue.
  • Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.

Surgical Scheduler

Southeast Texas Ear Nose and Throat
04.2002 - 01.2006
  • Coded correct procedures for physician and billing purposes.
  • Followed physician's orders and availability calendar to schedule tests and procedures.
  • Reached out to patients to confirm arrival times and convey procedures.
  • Contacted insurance companies to obtain authorizations and gathered all related medical records.
  • Expertly managed planning, scheduling, and coordination of outpatient procedures.
  • Verified insurance coverage and obtained pre-authorizations.
  • Arranged pre-operative and post-operative appointments for surgical patients.
  • Resolved scheduling conflicts to maintain high-quality patient services.
  • Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.

Education

No Degree - Health Administration

Lamar University
Beaumont, TX

High School Diploma -

Vidor High School

Skills

  • Conflict resolution techniques
  • Medical terminology proficiency
  • Medical billing
  • Healthcare regulations
  • Medical coding
  • Recordkeeping and data input
  • Resource information
  • Applicant support and service
  • Documentation and paperwork
  • Disability awareness
  • Verbal communication
  • Telephone etiquette
  • Documentation and reporting
  • Medicaid
  • Data entry
  • Confidentiality
  • Microsoft office

Timeline

Precertification Specialist

Baptist Hospital of Southeast Texas Cancer Center
01.2018 - 07.2025

Referral Coordinator

Joseph M. Finley M.D.
02.2006 - 01.2018

Surgical Scheduler

Southeast Texas Ear Nose and Throat
04.2002 - 01.2006

No Degree - Health Administration

Lamar University

High School Diploma -

Vidor High School

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