Melissa Hembree
Goshen,OH
Summary
Experienced Insurance specialist offering 5 years of experience. Detail-oriented team player with strong organizational skills.To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, customer service and to assist patients in obtaining health care services.
Overview
11
11
years of professional experience
Work History
Insurance Authorization Specialist
Ensemble Health Partners
Cincinnati, OH
02.2020 - Current
- Take opportunities to learn when occasion arise.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Developed and maintained productive working relationships with healthcare providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Obtaining authorizations for scheduled services by working patients account to verify eligibility of services, their insurance benefits, and obtaining clinicals needed to work their account. Answer customer calls, emails, and working closely with team members to meet daily goals. Take opportunities to learn when they arise.
Specialist Scheduling
Ensemble Health Partners
Cincinnati, Ohio
08.2018 - 02.2020
- Established rapport with callers to build loyalty and support
- Provided detailed information about available services and requirements.
- Updated accounts with latest information.
- Answered phone calls and answered questions from potential customers.
- Scheduler performs all scheduling duties for patients wanting services across the organization by selecting accurate medical records for patient safety and schedules appropriate procedures based on physician orders.
- Provides proper patient instructions, obtaining and validating demographic and insurance information, and provides excellent customer service.
- Scrubbing scheduled appointments for accuracy, proper documentation, orders and referrals.
- Responsible to complete more than 24 authorizations per day.
Store Manager
Widmer’s Dry Cleaners
Mariemont, Ohio
02.2016 - 12.2018
- Maintain monthly inventory, create weekly work schedules, balance daily transactions, track new customers, settle claims on damaged items, field customer complaints, take in items for alterations/ cleaning and train new associates.
- Managed inventory control, cash control, and store opening and closing procedures.
- Coached sales associates in product specifications, sales incentives, and selling techniques, significantly increasing customer satisfaction ratings.
- Rotated merchandise and displays to feature new products and promotions.
- Maximized sales and minimized shrinkage through excellent customer service and adherence to standard practices.
- Managed store employees successfully in fast-paced environment through proactive communication and positive feedback.
- Set effective store schedules based on forecasted customer levels, individual employee knowledge, and service requirements.
Loan Servicing Specialist
Union Savings Bank
Cincinnati, Ohio
08.2014 - 02.2016
- Process and organize all returned mortgage mail, receive customer service calls, verified information before updating Total Plus System, research, directed customer calls using a multi- line phone system, use of various office equipment including fax machine and copier.
Education
Associate of Applied Science - Applied Science
University of Cincinnati Clermont College
Batavia, OHCertification - Applied Science
Coding Certification
Batavia, OHAssociate of Science - Registered Health Information Technician
University of Cincinnati Clermont College
Batavia, OHSkills
- Analytical skills
- Dependable
- Confidentiality
- Professionalism and ethics
- Insurance verification expertise
- Teamwork orientation
- Strong communication skills
- Documentation management
- Medical terminology proficiency
- HIPAA compliance
- Benefit coverage
- Proficiency in Epic
- Strong work ethic
- Patient scheduling
- Computer skills
Timeline
Insurance Authorization Specialist
Ensemble Health Partners
02.2020 - Current
Specialist Scheduling
Ensemble Health Partners
08.2018 - 02.2020
Store Manager
Widmer’s Dry Cleaners
02.2016 - 12.2018
Loan Servicing Specialist
Union Savings Bank
08.2014 - 02.2016
Associate of Applied Science - Applied Science
University of Cincinnati Clermont College
Certification - Applied Science
Coding Certification
Associate of Science - Registered Health Information Technician
University of Cincinnati Clermont College