Marcia Waysome
Aworth,GA
Summary
Dynamic healthcare and administrative professional with over a decade of experience in mental health operations, patient coordination, insurance verification, scheduling, and provider services. Renowned for exceptional communication skills and meticulous attention to detail, consistently delivering superior service in high pressure healthcare settings. Adept at streamlining processes to enhance efficiency and patient satisfaction. Committed to fostering collaborative environments that support team objectives and promote excellence in patient care.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Administrative Assistant
Private Practice (Mental Health)
03.2024 - Current
- Investigated and evaluated insurance claims to determine coverage and liability.
- Verified insurance benefits by contacting insurance companies and collecting required documents.
- Screened and managed phone and email communication for executives.
- Coordinated onboarding activities and prepared new-hire paperwork.
- Responded to patient and client inquiries, providing accurate and timely information.
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
Referral Specialist II
Centene Corporation
04.2019 - 12.2023
- Processed outpatient and inpatient authorization requests in alignment with Medicare guidelines.
- Verified member eligibility, benefits, and medical documentation.
- Collaborated with providers to obtain necessary records.
- Ensured timely processing and accuracy of authorizations.
- Supported development and refinement of referral guidelines.
Customer Service Representative II
Centene Corporation
01.2016 - 02.2019
- Addressed escalated member and provider inquiries regarding claims and eligibility.
- Assisted users with portal navigation and plan resources.
- Identified claims discrepancies and coordinated adjustments.
- Maintained performance standards and quality metrics.
Administrative Assistant
Aerotek
05.2015 - 12.2015
- Managed internal communications, mail distribution, and administrative tasks.
- Utilized productivity software such as spreadsheets, databases, and word processing tools.
- Volunteered to help with special projects of varying degrees of complexity.
- Managed filing system, entered data and completed other clerical tasks.
MyCare Provider Services Navigator
Contemporary Staffing Solutions
11.2012 - 02.2015
- Responded to provider inquiries regarding claims, eligibility, and benefits.
- Verified authorization codes and ensured HIPAA compliance.
- Tracked claims and correspondence for accurate follow-up.
- Ensured timely processing and collaborated on issue resolution.
Education
Medical Billing And Coding
Ashworth College
Norcross, GA09.2020
High School Diploma -
Parkway Northwest High School
Philadelphia, PA01.2008
Skills
- HIPAA Compliance
- Insurance Verification
- Medical Billing & Coding
- Claims & Referral Coordination
- Patient Communication
- Microsoft Office & EMR Systems
- Scheduling & Calendar Management
- Data Confidentiality
- High Accuracy & Productivity
- Self-Starter & Fast Learner
- Customer service
- Medical terminology knowledge
- Coverage and authorizations
Certification
Medical Billing and Coding – Ashworth College (2019-02 – 2020-09)
Timeline
Administrative Assistant
Private Practice (Mental Health)
03.2024 - Current
Referral Specialist II
Centene Corporation
04.2019 - 12.2023
Customer Service Representative II
Centene Corporation
01.2016 - 02.2019
Administrative Assistant
Aerotek
05.2015 - 12.2015
MyCare Provider Services Navigator
Contemporary Staffing Solutions
11.2012 - 02.2015
Medical Billing And Coding
Ashworth College
High School Diploma -
Parkway Northwest High School