Megan Breann Downing
HIGH SPRINGS,FL
Summary
Attentive Assistant who provides skilled support to facilitate operational efficiency and meet challenging requirements. Highly organized, efficiency-driven, and proactive in handling simultaneous tasks. Excellent planning, problem-solving and decision-making abilities.
Overview
11
11
years of professional experience
Work History
Patient Access Representative
Florida Orthopaedic Institute
11.2023 - Current
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Provided exceptional customer service by addressing patient concerns regarding coverage and out-of-pocket expenses.
- Managed high-volume caseloads while maintaining strict deadlines for completing benefit verifications and authorizations.
- Ensured compliance with HIPAA regulations during all aspects of the benefit verification process, protecting patient privacy.
- Improved patient satisfaction by accurately verifying benefits and providing timely responses to inquiries.
- Leveraged advanced problem-solving skills in navigating complex cases involving multiple policies or payers, ultimately securing coverage approvals where possible.
- Streamlined pre-service financial clearance processes, expediting access to care for patients in need of urgent medical intervention.
- Expedited claim approvals by promptly submitting necessary documentation to insurance providers.
- Reduced claim denials with thorough insurance eligibility assessments prior to service provision.
- Served as a subject matter expert for peers and supervisory staff, providing guidance on best practices in benefit verification processes.
- Facilitated smooth transitions for patients between care providers by coordinating authorizations for outpatient services.
- Contributed to departmental goals by consistently meeting or exceeding performance metrics related to benefit verification accuracy and turnaround time.
- Built strong relationships with insurance representatives, fostering effective communication channels for resolving complex issues.
- Maintained up-to-date knowledge of insurance regulations, enabling accurate benefit verifications for various plans.
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
- Collaborated with other departments to address discrepancies or obtain additional information, ensuring accurate decision-making in the authorization process.
- Managed a high volume of correspondence with healthcare providers and clients, organizing emails and phone calls efficiently to ensure prompt responses.
- Informed customers of alternative options when authorizations were denied, providing guidance to support informed decisionmaking.
- Maximized accuracy of authorization decisions by thoroughly analyzing medical records and related documents against established criteria.
- Demonstrated exceptional attention to detail while handling sensitive personal information, adhering to HIPAA guidelines and maintaining confidentiality.
- Resolved escalated customer complaints diplomatically, addressing concerns promptly while maintaining a calm demeanour under pressure.
ACCOUNTING CLERK
INTERMED
03.2023 - 11.2023
- Enter/ import vendor invoices for processing
- Process vendor invoice for payment
- Download and investigate vendor statements
STAFF ASSISTANT
THE ORTHOPEDIC INSTITUTE
12.2015 - 03.2023
- Maintained positive working relationship with fellow staff and management
- Kept front desk presentable, managing incoming calls and visitors with utmost professionalism
- Prepared correspondence, reports, and other documents in final formats with correct punctuation, capitalization, grammar, and spelling
- Maintained front desk to provide positive first impression
- Handled incoming calls and directed callers to appropriate department or employee
- Answered incoming calls and recorded accurate messages
- Participated in credit and collections activities
- Used scheduling software to delegate resources and manage calendars
- Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability
- Performed verification of Medicare coverage
- Retained strong medical terminology understanding in effort to better comprehend procedures
- Created and sent time of service letter to inform patient of estimated self-pay balance
CNA
PEDIATRIC HEALTH CHOICE
06.2014 - 12.2015
- Exhibited compassionate care and communication regarding issues surrounding death and dying
- Used mobility devices to transport patients
- Turned and repositioned residents using proper body mechanics to prevent pressure ulcers
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation
Education
High School Diploma -
BELL HIGH SCHOOL
BELL, FLORIDA05.2013
Skills
- Accounting
- Claims processing
- Customer contact
- Billing and Invoicing
- Administrative duties
- Reception assistance
- Professional and mature
- Mail management
- Great people skills
- Document control
- Data entry
- Planning and organization
- Task prioritization
- Computer skills
- Reporting and Documentation
- Time management
- Microsoft office
- Knowledge of CPT and ICD-9/ICD-10 coding
- Modmed/Insight EMR/ Clinicient
- File and record keeping
- Multi-line phone systems
- Medical billing and collections
Timeline
Patient Access Representative
Florida Orthopaedic Institute
11.2023 - Current
ACCOUNTING CLERK
INTERMED
03.2023 - 11.2023
STAFF ASSISTANT
THE ORTHOPEDIC INSTITUTE
12.2015 - 03.2023
CNA
PEDIATRIC HEALTH CHOICE
06.2014 - 12.2015
High School Diploma -
BELL HIGH SCHOOL
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