Community Health Worker II with over 5 years of extensive experience in medical documentation, insurance management, and records maintenance, leveraging expertise in CPT-4, HCPCS, and ICD-9. Demonstrates proficiency in data entry and customer service, ensuring compliance with system policies and procedures while analyzing and correcting discharged patient accounts. Committed to enhancing healthcare efficiency and accuracy through innovative solutions and continuous skill development.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Community Health Worker II
Baylor Scott & White Health
01.2005 - 01.2024
Assisted patients through referrals from doctor’s office.
Outreached insurance.
Handled billings and codes. Fostered seamless communication between patients and healthcare providers, ensuring smooth referrals. Partnered with insurance companies to resolve complex cases. Developed team-oriented approach to billing and coding challenges.
Guided patients through referral process, providing compassionate support. Advocated for patients in insurance negotiations. Ensured accurate billing, alleviating financial stress for patients and healthcare providers.
Meticulously managed patient referrals, maintaining comprehensive documentation. Conducted thorough insurance verifications. Implemented rigorous quality control measures in billing and coding processes.
Spearheaded digital referral system, enhancing patient care efficiency. Optimized insurance processes, reducing claim resolution time. Streamlined billing procedures for faster reimbursements.
Remote
Connected families with necessary social services, alleviating barriers to healthcare access and improving quality of life.
Addressed patient concerns and provided support to vulnerable demographics.
Worked directly with patient treatment teams and participated in care coordination procedures.
Room Control Coordinator
Baylor Scott & White Health
01.2005 - 01.2022
Performed data entry, using Epic system.
Followed and ensured compliance of system and revenue cycle policies and procedures.
Managed insurance corrections and verification.
Analyzed errors in discharged patient accounts.
Leveraged knowledge of CPT-4, HCPCS, and ICD-9.
Oversaw bedding patients from ER / transfer facilities.
Maintained records of patient furlough, room rate adjustments, and in-house transfers.
Confirmed insurance, Medicare, and Medicaid.
Handled multiple calls per day to address customer inquiries and concerns.
Baylor Transfer Center
Baylor Scott & White Health
01.2017 - 01.2019
Leveraged knowledge of CPT-4, HCPCS, ICD-10, and medical documentation.
Managed bedding patients, using Epic system / bed board.
Oversaw insurance corrections and verification.
Maintained records of patient furlough, room rate adjustments, and in-house transfers.
Coordinated special transfers according to room availability and admission approval.
Community Health Worker at Baylor Scott&White Quality Alliance, Baylor Scott&White HealthCommunity Health Worker at Baylor Scott&White Quality Alliance, Baylor Scott&White Health