QMA, HMS, Intergy, MDX, SMS software programs
LAURA JONES
ADMINISTRATIVE ASSISTANT
Summary
Dependable Administrative Assistant serving diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Skilled at analyzing case files and databases to speed up inquiry response times and guide information through appropriate personnel channels. Maintains highest standards of ethics, professionalism and regulatory compliance to ease common stressors and de-escalate potential conflicts.
Overview
11
11
years of professional experience
1
1
Language
Work History
Patient Financial Coordinator
Fallbrook Hospital
04.2010 - 07.2011
- Assessed patients'' eligibility for financial assistance programs by conducting thorough reviews of their income and expenses, making appropriate recommendations based on individual circumstances.
- Developed relationships with community organizations, establishing referral networks for financial assistance programs available to patients.
- Assisted patients in understanding their benefits and coverage, clarifying complex insurance terms, and providing guidance on out-of-pocket expenses.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Trained new staff on filing, phone etiquette and other office duties.
Medical Biller and Collector
QMBC Management
12.2007 - 03.2010
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Improved customer satisfaction by effectively resolving delinquent accounts through negotiation and payment plans.
- Verified insurance of patients to determine eligibilit
Commercial and 3rd Party Insurance Collector
Inland Eye Specialist
12.2004 - 08.2007
- Prepared detailed reports on collection activities and account statuses for management review, enabling data-driven decision making within the department.
- Utilized advanced negotiation skills to secure favorable repayment terms while maintaining strong client relationships.
- Conducted thorough investigations of disputed claims, ensuring accurate resolutions for all parties involved.
- Regularly monitored outstanding accounts for changes in financial status or payment patterns, allowing for proactive response to potential issues.
- Processed debtor payments and updated accounts to reflect new balance.
- Streamlined the insurance collection process by implementing efficient tracking and follow-up systems.
Medical Insurance Collector
Southwest Healthcare System
03.2001 - 06.2003
- Negotiated payment plans with patients experiencing financial difficulties, increasing overall recovery rate for unpaid balances.
- Performed regular audits of assigned accounts to identify trends in non-payment or recurring errors requiring corrective action.
- Increased cash flow for the organization through diligent monitoring of insurance reimbursements and timely appeals of underpaid claims.
- Reduced claim denials through thorough research of insurance coverage, patient eligibility, and claim accuracy.
- Contributed to a reduction in aged accounts receivable by consistently tracking overdue balances and initiating appropriate collection efforts.
- Followed up on denied claims to verify timely patient payment and resolution.
- Monitored and updated claims status in claims processing system.
- Responded to correspondence from insurance companies.
- Processed insurance payments and maintained accurate documentation of payments.
- Monitored customer accounts for payment delinquency and initiated collection efforts.
- Processed debtor payments and updated accounts to reflect new balance.
Medi-cal Reimbursement Specialist
Loma Linda University Health Care
07.2000 - 02.2001
- Improved patient satisfaction by efficiently processing insurance claims and addressing concerns.
- Collaborated with healthcare providers to ensure accurate coding and billing practices.
- Maintained strict confidentiality regarding sensitive patient information, adhering to HIPAA regulations at all times.
- Resolved complex issues related to claim submissions, working closely with insurance representatives to achieve prompt resolutions.
- Expedited payment processing by submitting electronic claims promptly after services were rendered.
- Provided exceptional customer service during phone inquiries from both patients and insurance companies, resolving issues swiftly.
- Logged charges and payments within QMA software system.
- Processed online and paper appeal submissions and refund requests.
- Audited and corrected billing and posting documents for accuracy.
- Generated accounts payable reports for management review to aid in financial and business decision making.
Administrative Office Assistant II
Riverside County Regional Medical Center
02.2000 - 06.2000
- Facilitated interdepartmental collaboration through clear communication channels and regular status updates on ongoing projects.
- Enhanced communication between departments by coordinating meetings.
- Streamlined office operations by implementing efficient organizational systems and filing procedures.
- Managed day-to-day office tasks, ensuring a smooth workflow and timely completion of projects.
- Assisted coworkers and staff members with special tasks on daily basis.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
Education
Professional Medical Reimbursement
University of California Riverside Extension
Riverside, CADiploma - Medical Administrative Assistant
Concorde Career College
San Bernardino, CA 05.2001 -
Skills
Healthcare Industry Knowledge
Software
Microsoft Word and Excel
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Timeline
Patient Financial Coordinator
Fallbrook Hospital
04.2010 - 07.2011
Medical Biller and Collector
QMBC Management
12.2007 - 03.2010
Commercial and 3rd Party Insurance Collector
Inland Eye Specialist
12.2004 - 08.2007
Diploma - Medical Administrative Assistant
Concorde Career College
05.2001 -
Medical Insurance Collector
Southwest Healthcare System
03.2001 - 06.2003
Medi-cal Reimbursement Specialist
Loma Linda University Health Care
07.2000 - 02.2001
Administrative Office Assistant II
Riverside County Regional Medical Center
02.2000 - 06.2000
Professional Medical Reimbursement
University of California Riverside Extension