Melanie Small
Beaumont,TX
Summary
Friendly Insurance Verifier with over 10 years of experience as an insurance verifier. Looking to tackle new responsibilities in the medical insurance verification industry. Skilled at reviewing, analyzing, and interpreting various insurance policies. Hands-on individual boasting a career spent managing administrative tasks in fast-paced offices with relative ease. A well-trained Insurance Verification Specialist offering a background in contacting insurance companies for critical information and crafting patient documents for billing purposes.
Overview
27
27
years of professional experience
Work History
Customer Care Coordinator
Centene
08.2022 - Current
- Enroll members
- In Care Management verify benefits and insurance verification
Appeals and Grievances
Molina
05.2022 - 08.2022
- Help assist with claims denials
- Customer service
Customer Service
Optum
03.2022 - 05.2022
- Company Overview: Remote
- Answer phones from VA providers
- Help assist with claims
- Help assist with denials
- Remote
Referral Coordinator
Southeast Texas Medical Associates
Beaumont, TX
06.2016 - 03.2022
- Scheduled patients according to availability, urgency, and insurance authorization guidelines
- Managed up to 30 patient referrals daily through multi-line telephone system
- Verified documents and associated records to catch and resolve discrepancies
- Developed productive working relationships with numerous insurance company representatives
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines
- Answered questions and resolved concerns raised by both patients and specialists
- Reviewed demographic, clinical and insurance information before sending to referred specialists
Insurance Verification Specialist
Southeast Gastroenterology Associates
Beaumont, TX
08.2015 - 06.2018
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling
- Updated patient and insurance data and input changes into company computer system
- Checked documentation for appropriate coding, catching errors and making revisions
- Followed specific security rules and guidelines to protect patient medical records and payment card information
Front Desk Receptionist
Christus Health
Beaumont, TX
06.2012 - 12.2015
- Handled payment processing and provided customers with receipts and proper bills and change
- Welcomed patrons to front desk and engaged in friendly conversations while conducting check-in process
- Received incoming calls and coordinated with hotel staff to fulfill requests and resolve issues
- Prepared daily shift close reports and balanced cash register to accurately reflect all transactions
- Scheduled and confirmed appointments
- Answered and directed incoming calls using multi-line telephone system
- Answered phone calls, provided information to callers, and connected callers to appropriate people
- Greeted incoming patients and verified paperwork to manage smooth intake processes
- Delivered administrative support to team members, including making copies, sending faxes, organizing documents, and rearranging schedules
- Processed payments and updated accounts to reflect balance changes
- Pulled and organized requested documentation
- Delivered key administrative support to coworkers, taking on additional tasks during peak times
Business Office Assistant
Advanced Cardiovascular Specialists
Beaumont, TX
05.2010 - 06.2015
- Operated office equipment, such as copy machine, scanner, and printer
- Organized paper filing system to maintain accurate records
- Answered phone and routed calls to appropriate team members
- Answered multi-line phone system and accurately routed calls to correct individuals
- Greeted visitors with friendly and professional demeanor and provided direction to appropriate party
- Accepted and processed payments from customers in person and over telephone
- Completed various tasks for team members using copy machine and fax machine
- Greeted arriving customers and announced to appropriate employees
- Operated scanning equipment to scan records and verified accurate indexing and quality of scanned documents
- Scheduled appointments and maintained employee appointment calendar using MS Outlook
Medical Records Clerk
St. Elizabeth's Hospital
Beaumont, TX
05.1998 - 05.2010
- Scanned incoming documentation
- Maintained complete confidentiality in accordance with organization and legal requirements
- Observed confidentiality and safeguarded all patient-related information
- Kept department clean, organized, and professional
- Purged outdated files
- Pulled patient charts for upcoming appointments
- Consolidated diverse medical records
- Wrote reports, emails, memoranda, letters, and releases
- Disseminated information to correct department, individual or outside location
- Conceptualized and implemented new and more efficient filing system
- Verified, updated, and entered patient information into system
- Assisted with properly processing records requests
- Worked with speed, efficiency, and accuracy to process documentation and complete projects
- Utilized copying equipment for medical record duplication, answered phones and filed documents
- Completed patient paperwork and maintained accurate records
- Managed electronic health record quality assurance processes by organizing and handling requests for medical records and charts
- Worked with management to ensure paperwork was received and processed correctly
- Recorded and filed patient data and medical records
- Assisted professionals with different administrative tasks, which included coding and sending information to various departments
Education
Some College - Health Information Technology
Lamar Institute of Technology
Beaumont, TXSkills
- Insurance plan verification
- Skilled in Athena
- Skilled in Gems
- Skilled in CMeds
- Patient rapport
- Medical terminology
- Electronic authorization processing
- Medicaid knowledge
- Insurance terminology
- Organizational skills
- Training & Development
- Clerical
- Time management
- Collaboration
- Critical thinking
- Data management
Timeline
Customer Care Coordinator
Centene
08.2022 - Current
Appeals and Grievances
Molina
05.2022 - 08.2022
Customer Service
Optum
03.2022 - 05.2022
Referral Coordinator
Southeast Texas Medical Associates
06.2016 - 03.2022
Insurance Verification Specialist
Southeast Gastroenterology Associates
08.2015 - 06.2018
Front Desk Receptionist
Christus Health
06.2012 - 12.2015
Business Office Assistant
Advanced Cardiovascular Specialists
05.2010 - 06.2015
Medical Records Clerk
St. Elizabeth's Hospital
05.1998 - 05.2010
Some College - Health Information Technology
Lamar Institute of Technology
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