Marshae McGee
Loganville,GA
Summary
Logical Financial Revenue Cycle Professional with extensive history of speaking with patients, physicians and insurance company representatives. Efficient professional with more than 14 years of experience obtaining pre-admission paperwork, counseling patients and developing effective payment plans for healthcare services.
Overview
14
14
years of professional experience
Work History
Pre- Arrival Coordinator
University of North Carolina Hospital
Raleigh , NC
2023.12 - Current
- Responsible for the accurate and timely submission of claims, response to denials, and re-bills of insurance claims.
- Responsible for all aspects of insurance follow-up and collections including interfacing with internal and external departments to resolve discrepancies through charge corrections, payment corrections, writeoffs, refunds or other methods. Edit claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority (or escalate as needed) to meet and satisfy billing compliance guidelines for electronic submission.
- Contact insurance carriers to obtain authorizations and referral approvals for services and procedures.
- Research medical records to gather information and substantiate medical justification for procedures as required by insurance carriers. Submits requested medical information to insurance carrier.
Financial Counselor
Mayo Clinic Health System
Rochester , WI
2020.02 - 2023.10
- Responsible for the analysis and necessary corrections of patient invoices or accounts as it pertains to clean claim submissions or re-bills.
- Responsible for maintaining work queues. Access, review and respond to third party correspondence via Document Management system.
- Research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, credit balances, sequencing of charges, and non-payment of claims.
- Contact patients, physicians and insurance companies to obtain information necessary for invoice or account resolution through write-offs, reversals, adjustments, refunds or other methods.
- Verify claims adjudication utilizing appropriate resources and applications.
- Post payments (Insurance and/or Patient) and denials to patient invoices/accounts in a timely and accurate manner.
Financial Counselor
HonorHealth Hospital
Phoenix , AZ
2018.11 - 2020.01
- Verifies patients’ insurance coverage, eligibility, and Point of Service financial obligation for all scheduled services, and documents the system in detail. Adheres to all third party payer requirements for both government and commercial payers.
- Create, monitor, and report on process and performance improvement initiatives
- Ensures that an account is established for every scheduled patient. Obtains complete and accurate patient demographics, insurance plan and benefits information, and ensures treatment authorization is secured in advance of the scheduled procedure while maintaining a minimum accuracy rate on reviewed accounts
- Determines insurance eligibility and coverage, obtains/confirms authorization to avoid non-compliance and penalties to the patient, health system and physician.
- Communicates current Medicare requirements, HIPAA compliance and reimbursement criteria. Collaborates with Case Management to ensure patient status is correct and documentation is provided to insurances as needed.
- Creates and/or updates hospital account. Obtains and enters into hospital information system required patient demographics and insurance information in a timely manner after procedure is scheduled. Documents all information according to departmental guidelines. Provides feedback to supervisor on changes/updates implemented by insurances as obtained.
- Contacts patients to verify demographic information and to perform financial counseling prior to time of service. Collects patient responsibility due, provides information on payment plans and financial assistance as necessary. Follows department and network policies concerning discounts, package rates and basic financial assistance.
- Coordinate with the utilization management staff to determine benefits for reduced level of care (i.e. day care, outpatient).
- Collecting co-pays, coins, and deductibles from patients
Surgery Scheduling Coordinator/QRM
Kaiser Permanente
Atlanta , GA
2017.04 - 2018.10
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Entered orders into the EMR system efficiently and without errors.
- Compiled necessary documents for surgical billing packages.
- Determined prior authorizations for medication and outpatient procedures.
- Posted and adjusted payments from insurance companies.
- Accurately posted and sent out all medical claims.
- Accurately posted surgeries, hospital visits and payments for assigned carriers.
- Confidently and adeptly handled claim denials and/or appeals.
- Maintained strict patient and physician confidentiality.
- Submitted electronic/paper claims documentation for timely filing.
- Verified patients’ eligibility and claims status with insurance agencies.
- Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.
- Improved ED administration by compiling and analyzing data and identifying areas of improvement.
- Collected blood, tissue and other laboratory specimens and prepared them for lab testing.
- ICD- 9 and ICD- 10 trained.
- Maintained accuracy, completeness and security for medical records and health information.
- Reviewed charts and flagged incomplete or inaccurate information.
- Utilized Epic & Star to manage and confirm patient data, such as insurance, demographic and medical history information.
- Verified insurance coverage and obtained pre-authorizations.
- Successfully scheduled patient appointments and placed reminder calls to ensure exceptional customer experience.
- Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
- Reviewed and corrected claim errors to facilitate smooth processing.
- Used Epic to schedule appointments.
Clinical Care Coordinator II
Northside Hospital
Atlanta , GA
2010.06 - 2017.03
- Obtain and record vital signs on mother/baby, intake/output amounts, or other measures in medical record (McKesson) as designated.
- Assist mothers with breastfeeding, provides patient education relating to infant and self-care.
- Assist nurse/doctors with labs and surgical procedures.
- Collect blood specimen from mother/baby for blood glucose & various other lab tests.
- Transports patients, equipment, and specimens throughout the hospital.
- Provides customer service support to patients, guests, and staff by answering telephones, taking messages, routing calls to appropriate individual(s), greeting new admissions, conducting customer service rounds, and assist with service recovery.
- When appropriate, answers customer's questions and provides requested information as necessary.
- Provides customer service support to patients, guests, and staff by providing directions, paging requested individual(s), and distributing and collecting appropriate paperwork and forms as necessary.
- Maintains patient records and transcribes physician orders as necessary.
- Maintains patient census and patient identification information in computer system.
- Orders and maintains appropriate inventory of unit supplies.
- Performs quality control audits of electronic medical records.
- Coaches and trains new associates in appropriate clerical and or clinical duties.
- Enter data into computer system for billing.
- Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
- Prepared billing correspondence and maintained database to organize billing information.
Skills
- Customer service-oriented Medical Terminology
- Team Player Patient Charting (EPIC, McKesson)
- Time Management Complex problem solver
- Detail Oriented Microsoft Office proficiency
- Professional demeanor Critical thinker
- Medical billing HIPAA compliance
- CPR certification
- ICD 9 forms specialist
Education
Associate Of Applied Arts - Business
University of Phoenix
Tempe, AZTimeline
Pre- Arrival Coordinator
University of North Carolina Hospital
2023.12 - Current
Financial Counselor
Mayo Clinic Health System
2020.02 - 2023.10
Financial Counselor
HonorHealth Hospital
2018.11 - 2020.01
Surgery Scheduling Coordinator/QRM
Kaiser Permanente
2017.04 - 2018.10
Clinical Care Coordinator II
Northside Hospital
2010.06 - 2017.03
Associate Of Applied Arts - Business
University of Phoenix
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