Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows.
Overview
9
9
years of professional experience
2
2
years of post-secondary education
Work History
CSR
ROI Solutions, Inc
American Fork, UT
09.2021 - Current
Provided primary customer support to internal and external customers
Offered advice and assistance to customers, paying attention to special needs or wants
Answered customer telephone calls promptly to avoid on-hold wait times
Collected customer feedback and made process changes to exceed customer satisfaction goals
Assisted customers with setting appointments, special order requests and arranging merchandise pick-up
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
Answered constant flow of customer calls with minimal wait times
Boosted sales revenue by skillfully promoting diverse service options
Enumerator
US Census
Odessa, TX
10.2019 - 09.2021
Traveled door-to-door in assigned communities and requested participation in census interview, clearly explaining process and purpose
Assisted people in filling out surveys with complete and accurate information
Contacted interviewees to rectify survey issues and ask follow-up questions
Oversaw 8-member team of census enumerators, providing strategy training and guidance to successfully obtain interviews and adhere to procedures
Requested participation in brief exit interviews to obtain feedback for use in development of procedural improvements
Dispensed assignments to enumerator team and submitted completed work to supervisors
Maintained records of houses visited, surveys completed and money spent
Addressed non-responsive initial interviewees by conducting follow-up calls or in-person visits to promote census importance and rights of participation
Walked door to door and collected demographic information
Medical Claims Specialist
ProCare
Odessa, TX
08.2018 - 10.2019
Submitted electronic/paper claims documentation for timely filing
Managed large volume of medical claims on daily basis
Followed up on potentially fraudulent claims initiated by claims representatives
Reviewed provider coding information to report services and verify correctness
Responded to correspondence from insurance companies
Reported policy changes and company conditions affecting customer satisfaction
Used administrative guidelines as resource or to answer questions when processing medical claims
Verified client information by analyzing existing evidence on file
Maintained strong knowledge of basic medical terminology to better understand services and procedures
Posted payments to accounts and maintained records
Maintained confidentiality of patient finances, records and health statuses
HIM Assistant
Crane Memorial Hospital
Crane, TX
09.2017 - 08.2018
Verified the accuracy and overall completeness of medical records by auditing and reviewing patient information.
Processed records efficiently and oversaw timely project completion.
Organized medical record copy and chart requests to complete EHR quality maintenance procedures
Used medical center hardware and software to produce required reports.
Reviewed medical records and data after locating, retrieving, and sending them to appropriate places.
Copied medical records and performed various clerical tasks as required
Organized over 300 medical records through diverse systems of classification, storage, retrieval, and indexing.
Located, retrieved, sent and scanned medical record data.
Used an electronic health record system to scan, index and input over 1,000 documents.
HIM Assistant/Biller
OIMA
Odessa, TX
01.2014 - 09.2017
Executed billing tasks and recorded information in company databases
Collected data to complete detailed financial reports for stakeholders and management
Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered
Kept all patient information secure and confidential
Followed up with appropriate parties to obtain prompt payments
Reconciled past due accounts achieving 15% reduction in outstanding invoices
Determined proper codes for medical records and patient services
Contacted clients with past due accounts to formulate payment plans and discuss restructuring options
Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments
Used data entry skills to accurately document and input statements
Education
Associate of Applied Science - Medical Insurance Coding & Billing
University of Kansas Grantham
Lenexa, KS
05.2021 - Current
Certified Billing and Coding Specialist (CBCS) -
University of Kansas Grantham
Lenexa, KS
05.2021 - 12.2021
Skills
Data entry
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Additional Information
AWARDS
, Dean’s List March 2022
Dean’s List October 2021
Dean’s List January 2022
Dean’s List March 2022
Dean’s List June 2022
Timeline
CSR
ROI Solutions, Inc
09.2021 - Current
Associate of Applied Science - Medical Insurance Coding & Billing