Martha McCutcheon
Charleston,WV
Summary
Goal-driven Healthcare professional well-versed in recruiting, training and managing employees to provide exceptional services. Highly organized and hardworking with excellent planning and management skills.
Overview
23
23
years of professional experience
Work History
Referral Coordinator
WVU Medicine
05.2023 - Current
- Weighed patient need, provider availability, and insurance coverage to determine optimal scheduling.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Scheduled appointments with specialists on behalf of clients.
- Developed and implemented effective strategies to increase referral sources.
- Processed referral requests from patients, doctors and other health care professionals.
- Provided education and instruction to referral sources on referral processes.
- Attended continuing education courses to stay current on referral processes and best practices.
- Monitored referrals to foster timely completion and followed up with physicians to facilitate.
- Assisted with completion of referral forms and verified data accuracy and completion
- Developed and maintained strong working relationship with referral sources to streamline processing.
- Accessed and reviewed patient records to verify receipt completed referral paperwork.
- Responded to patient inquiries to offer timely updates regarding referral status.
- Facilitated referrals to other healthcare providers and resources to bridge service gaps.
- Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Schedules outpatients in accordance with scheduling guidelines, with the ability to prioritize according to patient needs.
- Answers phones from patients/customers professionally and responding to patient/customer inquiries and complaints.
- Schedules patients/customers based on scheduling guidelines and medical appropriateness.
- Research required information using accessible resources.
- Obtaining and collecting all necessary information from the patient/customer to schedule the appointment.
- Obtain authorizations for all imaging servies.
- Contating referring providers for additional clinical questions and to discuss Peer to Peer options for Denial purposes.
- Submitting appeals to insurance companies for Denials and answer any pertinant clinical questions to get Denials overturned.
- Contact insurance companies for Retro authorizations and answer clinical questions if needed.
Contact Central Scheduling Departments at different facilities for scheduling. - Answer all questions regarding CRO Process
- Oversee training for new employees for their pods
- Reports- Expense, Iround, Tracking Sent Report Sheets
- Remove roadblocks for team if needed.
- Train and QA (Quality Assurance) New Hires and Possible One on One for performance issues
- Monitor productivity and sit one on one with staff.
- Supervise daily operations within the call center, ensuring agents adhere to schedules, call handling protocols, and customer service standards.
Medical Assistant
Charleston Nephrology, Hypertension And Transplant
10.2022 - 03.2023
- Obtained client medical history, medication information, symptoms, and allergies.
- Documented vital signs and health history for patients in clinic and hospital environments.
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Referral Coordinator
- Schedule New patient referrals
- Obtain Authorizations for imaging and new patient appointments
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Performed medical records management, including filing, organizing and scanning documents.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Implemented care and efficiency improvements to support and enhance office operations.
- Explained procedures to patients to reduce anxieties and increase patient cooperation.
- Oriented and trained new staff on proper procedures and policies.
- Collected and documented patient medical information such as blood pressure and weight.
- Updated inventory, expiration and vaccine logs to maintain current tracking documentation.
- Obtained and documented patient medical history, vital signs and current complaints at intake.
- Helped improve patient outcomes by educating and advising on relevant treatments and care.
- Collected pertinent data and calculations to aid physician in interpreting results.
- Taught patients about medications, procedures, and care plan instructions.
Billing and Coding Coordinator/Certified Medical Assistant
Charleston Gynecology
09.2015 - 10.2022
- Entered data, generated reports, and produced tracking documents.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Completed bi-weekly payroll for employees.
- Hired, assisted with managing, developed and trained staff, established and monitored goals, and assisted with conducting performance reviews.
- Submit payments.
- Schedule procedures.
- Authorizations, Denials, Appeals for surgery and imaging.
- Obtain refill authorizations.
- create estimates for patient costs.
- Billing and submitting claims.
- Explain insurance benefits to patients and payment options.
Scheduling Assistant/ Precert Specialist
Dr. Foster
01.2013 - 12.2015
- Developed strong working relationships with management and executive team through effective scheduling and communication skills.
- Worked with manager and supervisor to plan and coordinate production schedules.
- Gathered employee data to develop monthly work schedules, enabling proper staffing for departments for each shift.
- Completed logs and reports detailing production data such as volume, materials used, and quality assurance results, helping management make accurate operational decisions.
- Check patient In and Out.
- Schedule procedures and testing.
- Obtain prior authorizations for procedures, infusions, office visits, and imaging.
- Submit appeals for denials.
- New patients referral.
- Run reports.
- Assist with EKG/EEG's.
- Merge patient charts.
- Create and update referral forms.
Front Office Manager
Elana Health
01.2009 - 11.2015
- Managed files and records for clients and adhered to safety procedures to prevent breaches and data misuse.
- Prepared reports to assist business leaders with key decision making and strategic operational planning.
- Coached employees through day-to-day work and complex problems.
- Supervised and guided new employees and responded quickly to questions to improve understanding of job responsibilities.
- Obtain authorizations for DME.
- Train personnel on office duties.
- Scanning.
- Faxing.
- Submitting orders
Medical Assistant
Dr. Skaff
08.2001 - 01.2009
- Obtained client medical history, medication information, symptoms, and allergies.
- Documented vital signs and health history for patients in clinic and hospital environments.
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Performed medical records management, including filing, organizing and scanning documents.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Implemented care and efficiency improvements to support and enhance office operations.
- Explained procedures to patients to reduce anxieties and increase patient cooperation.
- Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
- Completed EKGs and other tests based on patient presentation in office.
- Schedule procedures and tests.
- Ensure patients visits exceed expectations.
- Submit authorizations, appeals, work denails.
- Insurance verification.
- Injections.
Education
No Degree - Behavioral Health
West Virginia State College
Institute, WVAssociate of Science - Medical Assisting
National Institute of Technology, WV
06.2001
Skills
- Multi-line phone proficiency
- Appointment Scheduling
- Notetaking and documentation
- Multi-line telephone operation
- Billing/Coding
- Authorizations
- Management
Timeline
Referral Coordinator
WVU Medicine
05.2023 - Current
Medical Assistant
Charleston Nephrology, Hypertension And Transplant
10.2022 - 03.2023
Billing and Coding Coordinator/Certified Medical Assistant
Charleston Gynecology
09.2015 - 10.2022
Scheduling Assistant/ Precert Specialist
Dr. Foster
01.2013 - 12.2015
Front Office Manager
Elana Health
01.2009 - 11.2015
Medical Assistant
Dr. Skaff
08.2001 - 01.2009
No Degree - Behavioral Health
West Virginia State College
Associate of Science - Medical Assisting
National Institute of Technology, WV