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 sets by accumulating years of experience as a medical support assistant, financial counselor, medical collections/billing, and customer service representative. Giving me extensive knowledge across multiple areas in the work space; making me an asset within any company.
Overview
14
14
years of professional experience
Work History
Medical Support Assistant (GS 5)
VA Loma Linda (Audiology, Valor, Oncology)
01.2022 - Current
- Achieved effective communication by managing incoming calls and directing inquiries efficiently.
- Streamlined patient appointment management by overseeing scheduling, cancellations, and rescheduling.
- Facilitated collaboration with healthcare providers and social workers to meet diverse patient needs.
- Enhanced patient experience by managing check-in for scheduled appointments.
- Promoted a supportive and welcoming atmosphere for patients through teamwork with colleagues.
- Coordinated patient appointment times to improve clinic operational flow.
- Delivered prompt and courteous service to visitors and callers, fostering positive engagement.
- Resolved patient grievances promptly using active listening techniques to enhance satisfaction.
- Enhanced patient care by identifying and addressing the needs of patients, providers, and social workers.
- Supported patient access to resources by providing information on housing aid programs and workshops.
- Oriented and trained new staff on proper procedures and policies.
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
- Enhanced office workflow for medical staff by maintaining accurate records and timely data entry.
- Assisted in the reduction of appointment wait times by coordinating schedules and optimizing available resources.
- Contributed to a positive work environment through proactive problem-solving and excellent teamwork abilities.
- Maintained strict confidentiality, adhering to HIPAA regulations while handling sensitive patient information.
- Trained new staff on administrative procedures, promoting adherence to best practices within the department.
Patient Financial Counselor
Air Methods Corporation
06.2020 - 01.2022
- Manage all incoming/outgoing calls from and to patient's, insurance companies, and attorney's. Be able to transfer calls to appropriate departments and be an advocate for patient's by assisting in conference calls with the insurance.
- Collecting demographics, all insurance information, attorney information, or any other pertinent information that pertains to the date of service to get claims processed accurately, also updating Coordination of Benefits to ensure the correct party is being billed.
- Educating the patient on the billing process so they can have a better understanding on how the claim will be processed, giving them a better understanding on how their insurance coverage works.
- Responsible for getting payments that are sent to the subscribers by the insurance due to being out of network.
- Assisting patient's with any necessary appeals based on denials or underpayments by the patient's medical insurance
- Making financial arrangements for patient's who have balance after insurance and informing the patient of all coverage options, such as Medicaid or Charity Programs that we offer.
- Billing and Re-billing claims that are within timely filing and making sure that claims have all information necessary to get processed correctly, also following and adhering to the billing procedures and policies based on the initial pick up locations for any air transport.
- Communicate with outside entities such as hospitals, attorney's, labor funds, to ensure that we get the necessary supporting documentations or information needed so the claims can be processed.
- Most importantly we advocate for the patient from the beginning to the end so we can take some of the burden off the patient that has already been through so much.
Financial Counselor (Lab)
Loma Linda Medical Center
02.2017 - 06.2020
- Achieved accurate client registrations by efficiently gathering necessary demographic, employment, and insurance data. Secured client benefits through thorough verification of insurance coverage.
- Coordinated the acquisition of pre-certification authorizations and relevant billing addresses to streamline service delivery.
- Performs financial screening, making financial arrangements and assisting self-pay patients to find alternative ways of meeting their financial obligation including but not limited to charity screening and payment plans.
- As a Financial Counselor 1 working in the laboratory, another duty is ordering lab orders from outside providers. Making sure those outside labs align with the policy and procedure of LLUMC or LLUCH.
- Financial Counselor 1 has to effectively communicate with doctors' offices and other departments to ensure excellent patient care.
- The goal is to simply ensure that the patient has a great experience through anticipating patient needs by active listening, being efficient, and following all procedures and policies to the highest standard.
- Worked in the lab alongside of phlebotomist and communicated with providers to ensure lab orders were inputted correctly and that the patient orders were under their health care plan so patient can be aware of any financial responsibility.
- Provided financial counseling to patients, assisting with understanding billing processes and insurance options.
- Evaluated patient financial situations, recommending appropriate payment plans and resources for assistance.
Financial Analyst
Loma Linda University Health Care
11234 Anderson St
12.2016 - 01.2017
- Duties are to evaluate data, enter and record data from different sources. Recommend actions to management according to data.
- Recommend actions to management, and reconcile transactions by comparing and correcting data.
- Measuring financial performance against financial operating plans
- Preparing graphs and presentation materials
- Researching the 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 and accounts receivable data, income statements, balance sheets, and cash flow statements
- Providing recommendations designed to help facilities reduce their healthcare delivery costs
- Making recommendations about cost allocations
Customer Service Representative (LLMC)
Loma Linda Medical Center
11234 Anderson St.
07.2016 - 12.2016
- Achieved accurate patient account creation by efficiently gathering demographic, insurance, and guarantor information for Epic registration.
- Enhanced service authorization processes through effective collaboration with insurance verification units, medical groups, health plans, and primary care physicians, driving timely reimbursements.
- Optimized patient check-in by accurately reviewing estimates and collecting deductibles, co-payments, and cash rates as per contract terms.
- Maintained compliance with regulatory requirements and hospital policies, ensuring operational integrity.
Energy Advisor
Cloud Marketing Inc
Rancho Cucamonga, CA
05.2015 - 07.2016
- Achieved high customer satisfaction by promoting utility line home protection services and educating customers on energy efficiency options.
- Maximized efficiency in handling customer calls within a challenging call center environment.
- Mastered customer service scripts, delivering information within specified timeframes.
- Provided relevant and accurate information, addressing customer inquiries effectively.
- Enhanced team performance through targeted training on customer interaction techniques.
Medical Billing and Collections Specialist
Bureau Of Medical Economics
Phoenix, AZ
09.2012 - 04.2015
- Understanding of state-federal and HIPPA guidelines and laws.
- Meticulously identified and rectified inconsistencies, deficiencies, and discrepancies in medical documentation.
- Capacity for adhering to the company policy of confidentiality of information. Precisely completed appropriate claims paperwork, documentation, and system entry.
- Experienced with various insurances: Medicare, Medicaid, commercial insurances, HMOs, PPOs.
- Managed multiple assignments effectively. Ensured state and federal regulation compliance for medical collections. Reported patient and payer credit balances on a monthly basis.
- Submitted paper claims documentation for timely filing. Precisely evaluated and verified benefits and eligibility.
- Managed delinquent accounts initiating collection procedures as required.
- Worked with customers to establish patient payment plans.
Education
No Degree - Business
Arizona State University
Tempe, AZSkills
- Patient Management
- Patient-focused care
- Efficient and reliable team player
- Insurance claims
- Patient communication
- Patient Scheduling
- Medical billing and coding
- Able to work on multiple systems
- Excellent written and verbal skills
- Ability to multi-task while organizing and prioritizing workloads
Timeline
Medical Support Assistant (GS 5)
VA Loma Linda (Audiology, Valor, Oncology)
01.2022 - Current
Patient Financial Counselor
Air Methods Corporation
06.2020 - 01.2022
Financial Counselor (Lab)
Loma Linda Medical Center
02.2017 - 06.2020
Financial Analyst
Loma Linda University Health Care
12.2016 - 01.2017
Customer Service Representative (LLMC)
Loma Linda Medical Center
07.2016 - 12.2016
Energy Advisor
Cloud Marketing Inc
05.2015 - 07.2016
Medical Billing and Collections Specialist
Bureau Of Medical Economics
09.2012 - 04.2015
No Degree - Business
Arizona State University