Maranda Grizzle
Dahlonega,GA
Summary
Efficient Pre-Certification Coordinator known for high productivity and ability to complete tasks swiftly and accurately. Possess specialized skills in medical coding, insurance verification, and patient communication which ensure smooth pre-certification processes. Excel in time management, problem-solving, and interpersonal communication, facilitating effective collaboration with healthcare providers and insurance companies to streamline patient care coordination. Self-motivated insurance verification specialist proudly offering several years' experience building an understanding of medical terminology while tracking patient coverage. A poised professional with benefits explanation and administration expertise. Offering time management and interpersonal skills. Experienced and dependable general worker with a proven track record of efficiently completing tasks in various settings. Skilled in manual labor, equipment operation, and maintaining a clean and organized workspace. Safety-conscious with a strong work ethic and the ability to adapt to different environments. Ready to contribute to a dynamic team and make a positive impact.
Overview
4
4
years of professional experience
Work History
Billing Specialist
Cleaver Medical Group
Dahlonega, GA
06.2023 - Current
- Tracked changes in legislation that could affect billing procedures.
- Performed additional duties as assigned by management team.
- Developed financial reports detailing accounts receivable aging status.
- Answered customer inquiries regarding billings, payments, account status.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Generated periodic reports summarizing account balances and collection activities.
- Reconciled daily cash receipts with total deposits on bank statement.
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Implemented new policies related to billing processes when required.
- Input statement information, reconciled accounts and resolved discrepancies.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Processed invoice payments and recorded information in account database.
- Reconciled codes against services rendered.
Pre-Certification Coordinator
Cleaver Medical Group
Dahlonega, GA
10.2020 - Current
- Worked collaboratively with colleagues across departments to resolve any discrepancies or issues that arise during the course of pre-certification process.
- Compiled data into reports on a weekly basis to track productivity goals and meet deadlines.
- Initiated prior authorizations using electronic systems or paper forms as required by third party payers.
- Participated in training sessions regarding new procedures or changes in policies related to precertification activities.
- Assisted management with developing operational procedures for efficient processing of requests for preauthorization and precertification.
- Documented details of all interactions with patients and clients in the appropriate system.
- Developed strategies for problem solving complex cases that require additional research or analysis before approval can be granted.
- Ensured compliance with applicable regulations such as HIPAA Privacy Standards and CMS guidelines.
- Maintained records of all precertified services and related information.
- Reviewed and evaluated incoming requests for medical services in accordance with insurance requirements.
- Verified patient eligibility status through various sources including but not limited to telephone calls, faxes, emails .
- Managed multiple tasks simultaneously while meeting deadlines consistently.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Updated patient and insurance data and input changes into company computer system.
- Managed multiple tasks and priorities in a high-volume, fast-paced environment.
- Resolved insurance-related issues and discrepancies to prevent claim denials.
- Educated patients on their insurance benefits and coverage limitations.
- Worked closely with patients to discuss payment arrangements when needed.
- Provided support to other departments within the organization as needed.
- Managed all payments processing, invoicing and collections tasks.
- Submitted claims to insurance companies.
Education
High School Diploma -
Lumpkin County High School
Dahlonega, GA05-2012
Skills
- Patient Scheduling
- Strong Organization
- Medical terminology knowledge
- Insurance Verification
- HIPAA Compliance
- Coordination and Scheduling
- Understanding of medical terms
- Electronic authorization processing
Affiliations
- I am a mom of two, Who lives life to the fullest.
Timeline
Billing Specialist
Cleaver Medical Group
06.2023 - Current
Pre-Certification Coordinator
Cleaver Medical Group
10.2020 - Current
High School Diploma -
Lumpkin County High School
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