Linda McFarland
Fort Worth,TX
Summary
Caring Intake Specialist with proven skills in case management, client registration, credentialing and document processing. Highly organized and with an empathic communication style. Presenting with awesome customer service skills. Ready to bring 5+ years' experience to a rewarding to new position.
Overview
7
7
years of professional experience
Work History
Billing Specialist
Vital Care Infusion
03.2024 - Current
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Verify nd update all necessary pharmacy documents required for billing.
- Identify insurance liability versus patient liability for infusion services.
- Determine cost of pharmacy medication.
- Worked with multiple departments to check proper billing information.
- Developed and maintained billing procedures to make timely payments.
- Verified accuracy of accounts payable payments, resulting in 80% reduction in payment errors and check reissues
- Worked with multiple departments to check proper billing information
- Identified, researched, and resolved billing variances to maintain system accuracy and currency
- Kept vendor files accurate and up-to-date to expedite payment processing
Front Office Specialist
Texas Health Harris Methodist Hospital Fort Worth
01.2024 - 03.2024
- Ran form copies, faxed information and made phone calls to patients, other providers and insurance companies.
- Scheduled appointments, sent reminders and updated master calendar.
- Determined amounts due and accepted payments.
- Greeted, registered, and checked in patients.
- Maintain smoke alarms and cold storage for surgical equipment
- Verified patient insurance eligibility and determined co payment amounts if necessary
Utilization Management – Intake Specialist II /Customer Relations
SWHR – Southwestern Health Resources
05.2019 - 12.2023
- Assist patients in continuing appropriate life sustaining health care
- Highest priority in patient confidentiality
- Triage Inpatient request for proper routing purposes
- Daily and consistent communication with patient as advocate for care
- Process Pharmacy request with highest priority
- Obtain insurance authorization and pre-certification from major insurance carriers
- Process precertification request for Outpatient and Inpatient hospital procedures daily
- Process request for surgery procedures both urgent and elective
- Triage and process precertification request such as, MRI, CT, and all other radiology exams
- Notify member and providers status of authorization request
- Maintain information regarding authorization request required for Utilization Management department
- Access member and provider information via Acuity and Availity daily
- Adhere to all Medicare CMS guidelines
- Customer Service to include communication with providers to clarify patient information
- Customer service calls to hospitals and ambulatory surgery centers to coordinate services for members
- Communicate with providers via Acuity and Epicor systems
- Collaborate with doctors to resolve STAT cases and ensure timely processing
- Follow up on urgent request to ensure resolution
- Verify facilities and provider status in collaboration with Medicare
- Current with Medicare guidelines
- Verify accuracy of authorization request to ensure services performed are within guidelines
- Ensure procedure request completed within mandatory turnaround time per CMS guidelines
- Verify member eligibility and benefits with health plan
- Maintain current knowledge of ICD 10 codes as well as CPT codes
- Superior Customer / member service
- Excellent proficiency in Microsoft Word, Excel Spreadsheets, PowerPoint and SharePoint.
Patient Account Services/ Insurance Verification
Methodist Medical Center
02.2018 - 05.2019
- Verify member eligibility and benefits with health plan
- Excellent proficiency in Microsoft Word, Excel Spreadsheets, PowerPoint and SharePoint
- Superior customer / member service
- Current with Medicare guidelines
- Customer Service to include communication with providers to clarify patient information
- Verify patient account and payment information
- Calculate and determine balance due for patient account
- Contact patient regarding payment of balance
- Route to Patient Advocate if needed for payment options.
Customer Relations/ Customer Service Specialist
Teleperformance
08.2017 - 02.2018
- Extensive Customer Service managing average of 70 calls per day
- Maintain product rules and services
- Update customer files daily
- Verify points acquired through travel and hotel stay
- Research eligible hotels as well as other qualified transactions
- Complaint resolution specialist
- Identify and resolve credit/ debit discrepancies in customer accounts
- Work with minimal supervision.
Education
Associate of Arts - Surgical Technology
Tarrant County College District
Fort Worth, TX12.2025
Skills
- Precertification and Referral Management
- Extensive Customer Service
- Medical Billing and Coding
- Eligibility Review
- Credentialing
- Client Intake
- Verbal and Written Communication
- Relationship Building
- Maintaining Client Records
- Electronic Medical Record Software
- Attention to Detail
- Research and Analysis
- Records Management
- Triage Prior Authorization Request
- Data Confidentiality
- Microsoft Office
- Problem Solving
- Data Collection and Entry
- Medical Records Review
- Empathic Communication
- Conflict Mediation
- Records Maintenance
- Active Listening
- Microsoft Access
- Scheduling and Appointment Setting
- Eligibility Requirements
Timeline
Billing Specialist
Vital Care Infusion
03.2024 - Current
Front Office Specialist
Texas Health Harris Methodist Hospital Fort Worth
01.2024 - 03.2024
Utilization Management – Intake Specialist II /Customer Relations
SWHR – Southwestern Health Resources
05.2019 - 12.2023
Patient Account Services/ Insurance Verification
Methodist Medical Center
02.2018 - 05.2019
Customer Relations/ Customer Service Specialist
Teleperformance
08.2017 - 02.2018
Associate of Arts - Surgical Technology
Tarrant County College District
Similar Profiles
Munther SalehMunther Saleh
Specialty Pharmacy Manager at Dixie Vital Care Infusion ServicesSpecialty Pharmacy Manager at Dixie Vital Care Infusion Services
Brooke IsraelBrooke Israel
Staff Pharmacist at Vital Care Home InfusionStaff Pharmacist at Vital Care Home Infusion
Kennedy NewKennedy New
Infusion Nurse, Registered Nurse at Vital Care Home InfusionInfusion Nurse, Registered Nurse at Vital Care Home Infusion