Lisa Hughes
Sumerco,WV
Summary
Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs. Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities.
Overview
34
34
years of professional experience
Work History
Precertification Specialist
Pulmonary Associates Of Charleston/WVU Medicine
02.2012 - Current
- Scheduled appointments with patients to gather information and explain processes.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Performed various administrative tasks by filing, copying and faxing documents.
- Prepared and processed patient referrals and transfer requests.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Responded to correspondence from insurance companies.
Customer Service Representative
Element Federal Credit Union
01.2008 - 02.2012
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Assisted customers with navigating bank systems, completing transactions and opening or closing accounts.
- Educated customers about available services, products and bank resources.
- Addressed customer inquiries, requests and complaints with courtesy and professionalism.
- Answered bank phone lines and directed customers to appropriate department to address concerns.
- Strengthened customer relationships by upholding strict standards and delivering fast, friendly customer service.
- Processed various transactions with accuracy and according to bank standards and legal requirements.
- Reviewed information in customer accounts and made recommendations for new products and services.
- Went above and beyond with service to promote loyalty and support bank goals.
- Stayed current on banking products, services and regulations to continue delivering top-notch service and support.
- Consulted with customers on individual needs and offered solutions aligned with individual situations and preferences.
- Educated customers on online banking and mobile banking applications.
- Performed account maintenance by closing out accounts and changing customer addresses.
- Executed wire transfers, stop payments and account transfers.
- Calculated fees due, interest and change for customer transactions.
- Handled various accounting transactions.
- Counted, verified and handled bank deposits and armored car transactions.
Medical Office Manager
Living Well Medical Center
10.2001 - 01.2008
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations.
- Communicated effectively with staff members, physicians, and patients, employing active listening and interpersonal skills.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Provided proper scheduling of patients, ensuring timely, and effective allocation of resources and calendars.
- Addressed and remedied all patient or team member issues.
- Developed close working relationships with front office and back office staff.
- Oversaw accounting, budgeting, and financial reporting.
- Developed policies and procedures for effective practice management.
- Leveraged patient feedback and performed continuous process improvements to streamline day-to-day business operations and patient satisfaction.
- Created and implemented organizational policies and procedures.
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties.
- Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Identified opportunities to streamline processes and improve office operations and efficiency.
- Cultivated strong relationships with vendors and partners supporting administrative operations.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
Assistant Branch Manager
WesBanco Bank
01.1990 - 05.2001
- Responded to customer concerns, working with manager to significantly raise customer satisfaction ratings.
- Demonstrated knowledge of branch financial products, loans and lines of credit.
- Built rapport with account holders by reaching out with product recommendations and account updates.
- Supervised and evaluated staff to help improve skills, achieve daily objectives, and attain advancement.
- Developed and managed employee schedules, balancing individual requests and requirements with business needs.
- Generated financial and operational reports to assist management with business strategy.
- Directed promotion and brand loyalty efforts to build direct relationships with customers.
- Reviewed credit applications for risk factors and credit worthiness.
- Completed filings and upheld strict compliance with regulatory agencies and supervisors.
- Maintained friendly and professional customer interactions.
- Engaged employees in business processes with positive motivational techniques.
- Complied with regulatory guidelines and requirements.
- Examined customer loan applications for loan approvals and denials.
- Performed banking, business administration and financial tasks to guarantee five-star service for clients.
- Developed strategic plans for day-to-day financial operations.
Education
No Degree - Office Management
Duval High School
Griffithsville,WVSkills
- Telephone Etiquette
- Effective Communication Skills
- Benefits Verifications
- Eligibility Requirements
- Procedural Codes
- Paperwork and Documentation
- Administrative Support
- Office Support
- Outbound Calls
- Diagnostic Procedures
- Precertification Processing
- Diagnostic Evaluation
- HIPAA Regulations
- Applicant Support and Service
- Appointment Scheduling
- Call Transfers
- Medical Assistance
- Operational Requirements
- Program Knowledge
- Outpatient Procedures
- Gathering Referrals
- Customer Interaction
- Active Listening and Communication
- Patient Referral
- Referral Tracking
- Customer Accounts Management
- Confidential Records Management
- Patient Scheduling
- Referral Verification
- Patient Eligibility Requirements
- Insurance Authorizations
- Effective Listening
- Documentation
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
Precertification Specialist
Pulmonary Associates Of Charleston/WVU Medicine
02.2012 - Current
Customer Service Representative
Element Federal Credit Union
01.2008 - 02.2012
Medical Office Manager
Living Well Medical Center
10.2001 - 01.2008
Assistant Branch Manager
WesBanco Bank
01.1990 - 05.2001
No Degree - Office Management
Duval High School
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