KENTRINICH MALVEAUX
Houston,Tx
Summary
Senior Healthcare Administrator with over 7 years' experience in healthcare, from medical billing, claims, insurance verification, authorizations, appeals and provider services. A strong advocate of perpetual self-development and look for new opportunities for hands on experience. Provides stellar communication
abilities with an earned reputation for successfully achieving planned goals and objectives.
Overview
8
8
years of professional experience
Work History
FRONT DESK RECEPTIONIST II
TEXAS CHILDRENS PEDIATRICS
12.2022 - Current
- Verify primary insurance coverage for claims received EOBs while processing claims.
- Created and Maintained accurate member COB in Excel and COB workbench application.
- Tracked statuses of applications and approvals
- Conducted phone calls and initial MSP eligibility screening to potential members and families.
- Verified commercial and Medicaid eligibility
- Submits Medicaid applications to state agencies when requested on behalf of members.
- Collaborated with cross-functional teams to address discrepancies in patient information, ensuring accurate billing and reimbursement.
- Enhanced workflow efficiency by implementing streamlined benefit verification process.
- Provides high quality stakeholder experience, as required acceptable quality audit score and productivity.
- Negotiated payment plans for applicants with outstanding medical debts, achieving mutually beneficial arrangements that satisfied both parties'' needs.
- Provided Medicaid, Medicare and Low-Income (LIS) with eligibility details and document requirements.
PATIENT ACCESS REPRESENTATIVE II
UT PHYSICIANS
05.2021 - 11.2022
- Collecting patient's information such as patient details, medical history, and insurance information through EPIC
- Collect copayments and deductibles at time of check in or check out
- Acted as back-up to all aspects of Billing Customer Service Rep duties as needed. Perform all clinical office duties such as answering phones, scheduling, and fax etc
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Streamlined documentation processes through digitization efforts, reducing paperwork while maintaining data accuracy and security.
- Evaluate and respond to all aspects of written billing inquiries, including but not limited to billing
insurances, updating invoices, reviewing EOBs. - Made outbound calls to patients and clients, carriers, and/or any internal or external source as needed to resolve issues.
BANKRUPTCY SPECIALIST
NATIONAL BANKRUPTCY SERVICES
07.2019 - 07.2020
- Collaborated with attorneys and other legal personnel on bankruptcy documentation reviews, making necessary corrections
- Researched statutes, decisions, legal articles and codes
- Analyzed account payment histories, along with deed of trust to verify grantor, grantee, trustee and loan amounts for executive leadership.
- Reviewed Deed of Trust, Title Commitment and prior bankruptcies documents.
- Increased case resolution efficiency by streamlining bankruptcy review processes and documentation management.
- Expedited foreclosure prevention process for clients, conducting thorough evaluations of loan modification alternatives.
- Conducted detailed financial analyses to assess clients'' eligibility for various debt relief options such as Chapter 7 or Chapter 13 bankruptcies.
PATIENT ACCESS SCHEDULER
SUGARLAKES FAMILY PRACTICE
01.2018 - 07.2019
- Secured patient information and confidential medical records in compliance with HIPPA privacy rule standards to protect patient's privacy
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered
- Utilized knowledgeable of electronic medical record system and medical terminology in E-clinical.
- Performed various administrative tasks by filing, copying and faxing documents.
- Managed high call volumes while maintaining exceptional customer service standards for patients and healthcare providers alike.
- Negotiated payment plans for financially challenged patients, demonstrating compassion while ensuring fiscal responsibility for the organization.
- Trained new staff on hospital processes and procedures.
PATIENT ACCESS REPRESENTATIVE
MEMORIAL HERMANN HEALTHCARE SYSTEM
06.2016 - 01.2018
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits
- Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance related instructions
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
- Adhered to company policies and scripts to consistently achieve call-time and quality standards
- Performed various clerical duties by filing and faxing documents.
- Answered constant flow of customer calls with minimal wait times.
Education
BILLING & CODING/ NURSING -
TEXAS SOUTHERN UNIVERSITY
Houston, TX01.2013
DIPLOMA -
EAST BERNARD HIGH SCHOOL
East Bernard, TX05.2007
Skills
- Leadership Skills
- Strive Under Pressure
- Determination
- Enthusiasm
- Team Collaboration
- Verbal and Written Communication
- Proficient in EPIC, Medi-Share, Availity
- Computer Skills (Windows, Microsoft Word, Excel, Access, PowerPoint, Internet, and typing 60 WPM
- Outstanding reputation, talented, dynamic, and confident individual who thrives on complex team environments
- Data entry
- Multitasker
Timeline
FRONT DESK RECEPTIONIST II
TEXAS CHILDRENS PEDIATRICS
12.2022 - Current
PATIENT ACCESS REPRESENTATIVE II
UT PHYSICIANS
05.2021 - 11.2022
BANKRUPTCY SPECIALIST
NATIONAL BANKRUPTCY SERVICES
07.2019 - 07.2020
PATIENT ACCESS SCHEDULER
SUGARLAKES FAMILY PRACTICE
01.2018 - 07.2019
PATIENT ACCESS REPRESENTATIVE
MEMORIAL HERMANN HEALTHCARE SYSTEM
06.2016 - 01.2018
BILLING & CODING/ NURSING -
TEXAS SOUTHERN UNIVERSITY
DIPLOMA -
EAST BERNARD HIGH SCHOOL
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