Marcus Prophette
Fontana,CA
Summary
Highly motivated and hardworking individual who can multi-task with outstanding leadership qualities and customer service skills. Exceptional computer aptitude and telephone etiquette. Acquired diverse skill set by accumulating years of experience as a Medical Support Assistant (GS5), Financial Counselor 2, Medical Collections/Billing, and Customer Service Representative. Giving me extensive knowledge across multiple areas of discipline in the work place; making me an asset within VA Loma Linda Healthcare Systems Organization.
Overview
11
11
years of professional experience
Work History
Medical Support Assistant GS-5 (Audiology)
VA Loma Linda Healthcare System (40hrs Per Week)
01.2022 - Current
- Working in Audiology & Speech Pathology Service Clinic for 2 years.
- Observed & assisted Audiology Health Technician on the care and cleaning of the Hearing Aids.
- Ordered Hearing Aid batteries & accessories in ROES System for patients.
- Assisted patients in putting in batteries as well as giving them verbal instructions on how to clean Hearing Aids.
- Obtain knowledge of function of Hearing Aids through working closely with Audiology Health Technicians.
- Assisted patients by looking in ROES System to determine Warranty, Trial Period dates and last Audiogram testing.
- Extensive knowledge of different manufacturers of Hearing Aids and styles.
- Scheduled, cancelled, and rescheduled appointments for Hearing Test, Hearing Aid Fittings, and Repairs for Loma Linda, Palm Desert, Murrieta, Victorville clinics.
- Performed daily check ins for patient's scheduled appointments.
- Answered phones and provided general administrative support while anticipating need of patients and provider to ensure optimal patient care.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Trained new MSA's to Audiology Clinic, providing them with general knowledge of VA policies, procedures, as well as practices specific to the Audiology Clinic.
- Verifying and updating patient's demographics in ICB, CPRS, VISTA, VSE GUI, ROES, and Consult Tracking Manager (CTM) systems.
- Communicating with providers about patients care and needs on TEAMS, and inputting notes in CPRS so providers across board can be aware of patient care and needs.
- Handled patient concerns and complaints through active listening while staying within established guidelines and policies.
- Filing DBRS Reports (Disruptive Reporting System) as needed to ensure safety of our patient's and co-workers.
- Handled patient concerns and complaints through active listening while staying within established guidelines and policies.
- Assisted in Audiology Walk-In Hearing Aid Repair clinic to provide same day services for veterans needing repairs, adjustments and maintenance on Hearing Aids.
- Overall providing excellent customer service, by effectively communicating with hearing impaired veterans.
Patient Financial Counselor 2
Air Methods Corporation (40hrs Per Week)
06.2020 - 01.2022
- Manage all incoming/outgoing calls from and to patient's, insurance companies, and attorney's.
- Transferred calls to appropriate departments to ensure patient's get exact needs met.
- Advocated for patients with their insurances and attorney's by assisting patient's on conference calls so patient could have better understanding of their benefits and how their claims are processed.
- Assisting patient's on dealing with any disputes or discrepancies with their insurance by filing appeals on patient's behalf, guiding them for start to finish in appeals process.
- Collecting correct demographics, all insurance information, attorney info, or other pertinent information that pertains to date services were rendered so claim can be processed accurately and in timely manner.
- Updating Coordination of Benefits to ensure correct party is getting billed correctly.
- Collecting payments for any outstanding balances such as deductibles, copays, and self pay accounts.
- Making financial arrangements for patient's who has outstanding balance due, by informing them of all coverage options, such as Medicaid or Charity Programs that we offer.
- Providing patient's with information on how to apply for Medicaid.
- Responsible for recouping payments that were sent directly to insurance subscriber due to not being in network. Payments up to $80,000.
- Billing and Re-billing claims that are within timely filing making sure that all information is correct on claims to ensure claim is processed correctly.
- Adhering to billing procedures and policies based on initial pick up locations for any air transport.
- Communicate effectively with outside entities such as hospitals, attorney's, labor funds, and Air transport staff to ensure we get necessary supporting documentation to submit with claims for maximum payout.
- General Administrative duties such as email, faxing, creating reports.
- Most importantly we advocated for patient from beginning to end so we can take burden off patient that had already been through so much.
Financial Counselor (Lab)
Loma Linda Medical Center (40hrs Per Week)
02.2017 - 06.2020
- Gathered general demographics such as address, phone numbers, emergency contacts, employment, and insurance data necessary for over 100 patient's daily.
- Verified patient by three identifiers such as date of birth, address, and last four of social security numbers.
- Verified insurance coverage and benefits.
- Collected co-pays and deductibles owed at time of service.
- Extensive knowledge of HIPAA Act, that supports privacy and security of patient's health information.
- Obtained pre-certification, authorizations for services to be rendered and obtain applicable medical group or health plan billing addresses.
- Performs financial screening, making financial arrangements assisting self-pay patients in finding alternative ways of meeting their financial obligation including but not limiting to charity screening and payment plans.
- Worked in lab with phlebotomist, so we had to order lab work in EPIC System from outside providers.
- Pull and check in labs that doctor placed into system, ensuring that labs match with patient's paperwork.
- Make sure outside labs align with policy and procedure of LLUMC or LLUCH.
- Be able to effectively communicate with doctors offices, and other departments within hospital to ensure excellent patient care.
- Ensure excellent patient care through active listening, anticipating needs of patient and provider, being efficient, detail oriented, and following all procedures and policies to highest standard.
Financial Analyst (Loma Linda Medical Center)
AppleOne Employment Services (40hrs Per Week)
12.2016 - 01.2017
- Duties were to evaluate data, enter and record data from different sources.
- Reconciled transactions by comparing and correcting data
- Measuring financial performance against financial operating plans.
- Preparing graphs and presentation material.
- Researching potential impact of operational changes to departmental and institutional budgets.
- Preparing profit and. Loss (P and L) reports
- Forecasting operational expenses
- Gathering, assessing, and interpreting financial data, such as accounts payable, accounts receivable data, balance sheets, and cash flow statements.
- Provided recommendations designed to help facilities reduce their healthcare delivery costs.
- Make recommendations about cost allocations.
Customer Service Representative (LLUMC)
AppleOne Employment Services (40hrs Per Week)
07.2016 - 12.2016
- Duties are to obtain patient's demographics, insurance, and guarantor information required to ensure that complete and accurate accounts are produced.
- Collaborate with Insurance Verification Unit, Medical Groups, Health Plans, and Primary Care Physicians to ensure authorizations for services and/or treatment ensuring accurate billing and timely reimbursement from the payers.
- Reviewed estimates and collected all deductibles, co-payments, and cash rates in accordance with terms and conditions of various contracts still outstanding at time of check-in.
- Ensures compliance with mandated Federal, State, and County regulatory requirements and hospital policies.
Medical Billing and Collections Specialist
Bureau Of Medical Economics (40hrs Per Week)
09.2012 - 04.2016
- Experienced Healthcare Collector, with extensive understanding of State, Federal, HIPAA guidelines and laws.
- Collected A/R for doctor's office and other medical facilities, for open patient's accounts after 90 days from date of service.
- Apply Electronic Skip Tracing Searches to track patients.
- Reported delinquent accounts to credit bureaus.
- Processed Credit Card Payment and Check payments by phone.
- Communicate with attorney's regarding lawsuits for medical payments.
- Assisted with Electronic Chapter 13 Bankruptcy Filings.
- Experienced in Avaya Call Center Technology.
- Verified Insurances electronically so see if we could still bill claim out due to timely filing.
- Set up reoccurring payment plans for patient's.
- Answered over 100 phone calls daily.
- Practiced Quality Assurance and Compliance on recorded calls.
- Communicated daily with our full service legal department.
- Perform NCOA (National Change of Address) Scrubs on accounts.
- Assisted in reconciling deposit and patient collections
- Compiled and tracked outstanding balances owed to medical facilities
Skills
- Knowledgeable in ROES System
- Knowledge of cleaning Hearing Aids
- Ordering Hearing Aids batteries and accessories
- Proficient in CPRS, VISTA, VSE Gui, ICB
- Employee Training
- HIPAA Training
- Appointment Scheduling
- Patient Communication
- Insurance Verification
- Medical Billing and Coding
- MS Word
- MS Excel
- Medical Terminology
- Basic knowledge of ICD 10 Codes
- Multi- line phone operation
- Order Entry
- Trust Commerce
- Medical Collections
- Medical Records
- Quality Assurance
- Organizational Skills
- Verbal Communication
- Basic Math
- Decision-Making
Timeline
Medical Support Assistant GS-5 (Audiology)
VA Loma Linda Healthcare System (40hrs Per Week)
01.2022 - Current
Patient Financial Counselor 2
Air Methods Corporation (40hrs Per Week)
06.2020 - 01.2022
Financial Counselor (Lab)
Loma Linda Medical Center (40hrs Per Week)
02.2017 - 06.2020
Financial Analyst (Loma Linda Medical Center)
AppleOne Employment Services (40hrs Per Week)
12.2016 - 01.2017
Customer Service Representative (LLUMC)
AppleOne Employment Services (40hrs Per Week)
07.2016 - 12.2016
Medical Billing and Collections Specialist
Bureau Of Medical Economics (40hrs Per Week)
09.2012 - 04.2016