Kim Cranton
OrthoArizona
Peoria,AZ
1
Language
23
years of professional experience
Hardworking Patient Financial Services Representative with 9 years of experience in healthcare administration and insurance verification. Proven expertise in managing patient relations, coordinating billing processes, and ensuring accurate prior authorizations. Skilled in utilizing medical software and maintaining compliance with HIPAA regulations. Demonstrated ability to enhance patient satisfaction through effective communication and problem-solving, seeking to leverage extensive experience in a remote patient service representative role.
Work History
Eligibility And Prior Authorization Specialist
2 Years 10 Months- Verify patient insurance and benefits for specific ICD 10 codes and apply benefit information to ensure proper payment and billing.
- Working with all prominent commercial and Medicare/Medicare Advantage plans to obtain all authorizations for all patient treatment.
- Utilizing various insurance portals and medical software including Athena and ModMed.
- Entering accurate information in EMR.
- Maintaining clear communication between providers, patient and insurance companies.
Patient Financial Services /Office Manager
9 Years- Verified insurance and obtain prior authorization
- Prepared patients finances based on insurance and treatment recommendations.
- Presented patients financial responsibilities to patient and answer any questions
- Patient intake consultation
- Patient relations addressing any concerns patient may have and resolving to retain customer satisfaction
- Directs patient flow
- Answers and screens telephone calls
- Takes accurate messages or directs call to appropriate person
- Greets and directs patients, families, visitors and staff
- Responds to requests in a timely manner and provides clear, accurate information within scope of knowledge and authority
- Updates patient demographic and insurance information as necessary and obtains specialist referrals for all patient appointments
- Schedules patient appointments utilizing scheduling tools and resources
- Coordinates and communicates ancillary appointments and procedures working with other hospital staff as needed
- Obtains patient information and materials as needed from referral sources
- Prepares patient records for clinical activities and maintains patient records for physicians
- Acts as liaison with other departments and external customers in a calm and supportive manner
- Handles confidential information appropriately and explains policies and procedures when necessary.
- Collects co-payments from patients at point-of-service
- Coordinates billing tickets for office visits and services following established procedures
- Forwards all billing fee tickets according to protocol to billing staff
- Reconciles collections at the end of the business day per established protocol
- Maintains clinical and administrative schedules and calendars
- Types correspondence, manuscripts and/or other documents
- Transcribes letters and patient notes as needed for physicians and facilitates in clinical computer systems.
- Prepares and distributes routine reports
- Notifies, confirms, and reminds patients of scheduled appointments such as consultation, follow up, or simulation via letters or phone calls
- Obtains authorization for treatments as needed
- Monitor staff performance and coaching
Front Office Associate
6 Years 3 Months- Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
- Reviewed files, records and other documents to obtain information and respond to requests.
- Sorted and distributed incoming mail and prepared outgoing mail.
- Maintained transaction security by verifying payment cards against identification.
- Schedule patient appointments accordingly to ensure maximum schedule efficiency.
Petshotel Manager
5 Years- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maintained professional, organized, and safe environment for employees and patrons.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Ensure accurate and efficient schedule.
Education
GED
Skills
Achieved timely processing of prior authorizations
enhancing claim approval rates.
Delivered high-quality customer service
resulting in increased patient retention.
Optimized medical scheduling
reducing appointment wait times.
Maintained accuracy in medical records
ensuring compliance with HIPAA standards.
Streamlined accounts receivable processes
improving financial reporting accuracy.
Applied medical terminology effectively to enhance communication with healthcare teams.
Languages
English
Additional Information
Authorized to work in the US for any employer
Timeline
Eligibility And Prior Authorization Specialist
OrthoArizona
10.2023 - CurrentRead More
Patient Financial Services /Office Manager
AFC Physical Medicine & Chiropractic Desert Ridge
08.2014 - 08.2023Read More
Front Office Associate
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05.2008 - 08.2014Read More
Petshotel Manager
Petsmart
08.2003 - 08.2008Read More
Home Schooled
GED
Read More