Kourtne Banks

- Responsible for managing patient accounts and providing comprehensive billing support for genetic counseling services. Review and process insurance claims, verify insurance eligibility and benefits, resolve billing issues, and educate patients on their financial responsibility. Serve as a liaison between patients, insurance providers, and internal teams to ensure accurate billing, timely claim resolution, and exceptional customer service.

• Reviewing and processing patient billing and insurance claims accurately.
• Verifying insurance eligibility, benefits, and coverage.
• Investigating and resolving claim denials, rejections, and payment discrepancies.
• Communicating with patients to explain billing statements, insurance benefits, and financial responsibilities.
• Processing payments, adjustments, refunds, and payment arrangements according to company policies.
• Maintaining detailed and accurate documentation of all patient and insurance communications.
• Collaborating with insurance providers and internal departments to ensure timely claim resolution.
• Ensuring compliance with HIPAA regulations, billing guidelines, and company policies.
• Providing excellent customer service while handling sensitive financial information with professionalism and confidentiality.

• Reached out to insurances to obtain patients eligibility
• Confirmed we had accurate DED and out-of-pocket amount and accumulations.
• Confirmed patient cost shares.

• Assisted providers with confirming members' benefits and eligibility.
• Review medical claims. Discussed and reviewed explanation of benefits with providers and member; how a claim was paid or denied.
• Assisted members with finding in network providers.
• Help members schedule first-time appointments with new providers coming in as a new patient.
• Review medical claims. Discussed and review explanation of benefits with providers and member; how a claim was paid or denied.
• Briefly reviewed and discussed deductibles, coinsurance, copayments and patient responsibilities to both providers and members.
• Supported members in establishing single case agreements for access to out-of-network providers.
• Facilitated prior authorization processes to ensure timely access to necessary services.
• Provided benefit concierge services to assist members in understanding their coverage options.
• Performed job responsibilities remotely, ensuring effective communication and collaboration.
• Assisted with prescription coverage.

• Reached out to providers to obtain valid prescriptions, charts' notes, updated A1C that was needed to prior to submission for Prior authorization or to send out medical supplies.
• Review prescriptions to validate we have all matching patient information and ICD-10
• Verify patients’ insurance to confirmed deductibles, out of pocket accumulations, copayments, coinsurance.
• Verify patients’ insurance to confirm deductibles, out of pocket accumulations, copayments, coinsurance.
• Managed voicemails, web orders, and emails to ensure timely communication with patients.
• Explained to patients why a Prior authorization has been denied.

• Handled inbound and outbound calls to address member inquiries and resolve issues
• High call volume environment
• Documented calls between members and third-party vendors to ensure accurate record-keeping
• Scheduled non-emergency transportation for doctor appointments such as chemotherapy dialysis, cardiologist, primary care doctor visits
• Utilized medical terminology to communicate effectively with healthcare professionals.
• Verified medical insurance and followed up with healthcare providers to confirm appointments

• Operated cash register efficiently and accurately, processed payments by cash, check, credit card, gift card or automatic debit.
• Operated register to process payments and collect cash payments for order order totals.
• Mastered essential tasks promptly to enhance overall productivity.
• Supported team objectives by completing tasks accurately and on time.
• Operated register to process payments and collect cash payments for order totals.
• Fostered collaborative relationships with coworkers and managers to improve team dynamics.
• Developed strong cooperative relationships with coworkers and managers.

Graduated High School