Krystal Ecford
Sapulpa
Summary
Team-oriented professional prepared to take on leadership responsibilities with a focus on driving results and fostering collaboration. Proven success in managing teams, overseeing project execution, and adapting to dynamic work environments. Known for reliability, flexibility, and strong organizational skills, ensuring seamless team operations and achievement of goals.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Case Manager
Pro-Spectus
Huntington Beach, CA
09.2023 - Current
- Facilitated communication between families and healthcare providers.
- Conducted regular follow-ups to evaluate service effectiveness and satisfaction.
- Implemented best practices for case documentation and record-keeping.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
- Maintained detailed documentation on each case, ensuring accuracy and compliance with legal requirements.
- Developed and maintained strong relationships with healthcare providers to streamline referral processes.
- Worked closely with insurance companies to verify coverage details and obtain necessary authorizations for services rendered.
- Reviewed and processed prior authorization requests for accuracy and compliance with established guidelines.
- Collaborated with healthcare providers to obtain necessary documentation for timely authorization approvals.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Provided training to new staff members on the intricacies of various insurance plans and their specific prior authorization requirements.
Medical Biller/Enteral Feeding Team Lead
Barber DME Supply Group
Chantilly, United States
02.2016 - 09.2023
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Posted charges, payments and adjustments.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Functions as a dedicated food and nutrition team lead to address the nutritional needs of patients.
- Entered client information and files into databases for further review and tracking.
- Managed intake of new claims and performed routine follow-ups.
- Led cross-functional teams to enhance operational efficiency and drive process improvements.
- Reviewed and corrected billing discrepancies, improving revenue cycle efficiency.
- Trained junior staff on billing procedures and best practices for accuracy.
- Led team initiatives to streamline claim submissions, reducing turnaround time.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Developed strategic initiatives to align departmental goals with organizational objectives.
Medical Assistant (Externship)
NOVA FOOT AND ANKLE CENTER
Alexandria, United States
10.2015 - 01.2016
- Scheduled appointments for patients via phone and in person.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Measured vital signs and took medical histories to prepare patients for examination.
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Organized charts, documents and supplies to maintain team productivity.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Cleaned and maintained medical equipment following procedures and standards.
- Documented notes during patient visits.
- Responded to patient callbacks and phone-in prescription refill requests.
- Contacted pharmacies to submit and refill patients' prescriptions.
Education
Bachelor of Science - Healthcare Administration
Southern New Hampshire University
Hooksett, NH05-2027
Certified Medical Assistant -
Everest College
Woodbridge, United States08.2023
Skills
- Problem solving
- Critical thinking
- Time management
- Communication
- Multitasking and Organization
- Claims Processing
- HIPAA Compliance Certification
- Case management
- Case documentation
- Documentation and reporting
- Conflict resolution
- Positive attitude
Certification
Certified Medical Assistant (CMA)
Timeline
Case Manager
Pro-Spectus
09.2023 - Current
Medical Biller/Enteral Feeding Team Lead
Barber DME Supply Group
02.2016 - 09.2023
Medical Assistant (Externship)
NOVA FOOT AND ANKLE CENTER
10.2015 - 01.2016
Bachelor of Science - Healthcare Administration
Southern New Hampshire University
Certified Medical Assistant -
Everest College