Melissa Rogers
Chicago,IL
Summary
I am an employee whom embodies:
17+ years of hands-on experience in physician office and clinical Administration
Strong written and oral communication skills.
The ability to learn quickly, multi-task and train others.
A passion to learn and to increase my skills
You will see from my attached resume that I meet all of these qualifications and more.
I treat the patients and staff that I serve with respect, compassion and am dedicated to making every experience a positive one.
I am reliable, detail-oriented, and extremely hard-working associate(one who will serve with a high standard of professionalism. Thank you for taking the time to review my resume.
Overview
14
14
years of professional experience
Work History
Home Care Aide Coordinator
Premier Home Health Care
Oak Park, IL
06.2022 - Current
- Supervised daily activities and provided assistance to staff.
- Create, maintain and adjust Aide client service schedules.
- enter and reconcile weekly Aide payroll.
- facilitate client staffing in accordance with MCO provided authorizations and City Respite service parameters.
- Communicate and reconcile Aide payroll discrepancies and time off requests via e-mail, telephone and in person.
- Create incident reports as required.
- I am a State mandated reporter
Authorization Coordinator
Help At Home
Chicago, IL
05.2019 - 12.2021
- Receive, review and process authorizations received from MCOs.
- Verify participant service eligibility (ensuring active waiver).
- Corresponding with HAH service Branches and MCOs via e-mail and phone.
- Create/Update demographic and authorization information appropriately as received.
- Assist HAH Branches with any participant service/hour inquiries/requests via e-mail and/or phone
Referral Specialist
Next Level Health
Chicago, IL
12.2018 - 05.2019
- Review, create and direct prior authorization requests to clinical staff for timely determination.
- Review, create and approve Labor & delivery, some DME and custodial prior authorization requests.
- Inbound inquiries regarding prior authorization request statuses, guidelines and denials.
- outbound calls with facility/providers regarding incomplete prior authorization requests.
Registration Specialist II
Loyola University Medical Center
Maywood, IL
02.2016 - 12.2018
- Verify prior authorization requirements, initiate, obtain and document prior authorization requests for ambulatory services (ie :high cost drug infusions, multiple ambulatory procedure types, radiological services, therapy(PT/ST/OT).
- Accurately maintain patient registration profiles.
- Communicate with patients and internal staff.
- regarding insurance rules/restrictions and any financial obligations relating to patient's medical coverage in lieu of scheduled services.
- Identify and communicate service flow challenges with organizational leadership.
- Receive assist/process/redirect inbound calls appropriately.
- Participate in System/application Uplift projects as needed.
Referral Specialist I
Aim Special
Westchester , IL
09.2014 - 12.2015
- Responsible for providing support to a clinical team facilitating the administrative component of clinical referrals for various services.
- Initiate and manage clinical referrals for pre-authorization.
- Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
- Assigns escalated referrals to staff as appropriate.
- Responds to inbound calls initiating exam requests following established processes.
- meets quality and production standards.
- Enters referrals, documents communications and actions in Epic database.
Underwriting Support Specialist
Combined Insurance
Chicago, IL
02.2011 - 06.2014
- Provide support for insurance underwriters(health, life, income protection, Cancer care and accident products).
- Collect/document applicant health history and financial information via phone interview.
- Input relevant data, prepare determination letters and other required policy documentation.
- Request, receive and electronically associate medical records via third party vendor.
- Assist Combined agents with marketing rules, policies and procedures via telephone.
- Administrative tasks as assigned. Train new Support associates on basic procedures.
Client Services Representative
Quest Diagnostics
Wood Dale , IL
01.2010 - 01.2011
- ` Answer calls of clinical and technical nature; reporting patient results and resolving general inquiries.
- Schedule patient appointments for Quest Patient Service Center.
- Generate billing adjustments and provided basic test pricing.
- Assists phlebotomists/physicians with specimens collection requirements.
Senior Secretary
Loyola University Medical Center
Maywood , IL
01.2004 - 01.2006
- Compose Physician release letter for patient's employer.
- Correct and print transcription for section Director.
- Create, request, register and maintain patient records.
- Process and schedule patient clinic appointments.
- Provide support for secretarial team as needed.
- filing, faxing, copying, retrieving and distributing section mail.
Education
High School Diploma -
Proviso East Highschool
Maywood06.1997
Skills
- Microsoft Office, Outlook and Excel
- Lotus Notes
- Group Wise
- Millbrook Practice Management
- Centricity Physician Management
- Epic Web Patient Care Systems, Clinical Workstation,
- Electronic transfer system
- OneSource
- Peer Utilization Review System
- Content Manager and Clarify Verisk Health-formerly MediConnect
- MRS (management Research Services)
- DataFlex Group Wise
- Record Shipping,
- Dictation, Documentation, Transcription Medical
- Terminology/Body Systems Training (certificate 2002)
Timeline
Home Care Aide Coordinator
Premier Home Health Care
06.2022 - Current
Authorization Coordinator
Help At Home
05.2019 - 12.2021
Referral Specialist
Next Level Health
12.2018 - 05.2019
Registration Specialist II
Loyola University Medical Center
02.2016 - 12.2018
Referral Specialist I
Aim Special
09.2014 - 12.2015
Underwriting Support Specialist
Combined Insurance
02.2011 - 06.2014
Client Services Representative
Quest Diagnostics
01.2010 - 01.2011
Senior Secretary
Loyola University Medical Center
01.2004 - 01.2006
High School Diploma -
Proviso East Highschool
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