MICHELE M OLDHAM
Foley,USA
Summary
Results-driven Eligibility Representative with expertise in insurance benefits verification and exceptional customer service. At Community Health Systems, successfully navigated complex eligibility determinations and enhanced operational efficiency. Proficient in electronic medical records and adept at coordinating patient care, ensuring compliance with coverage authorizations while fostering effective communication with diverse stakeholders.
Overview
25
25
years of professional experience
Work History
Eligibility Representative
Community Health Systems
Foley, Alabama
04.2022 - Current
- Verified detailed insurance benefits, medical necessity, and authorization/referral guidelines.
- Screen referred self-pay patients for programs such as Medicare, Medicaid, Crime Victims, QMB, SSI, and any/all other third party coverage including other available local, state, and federal programs in addition to the hospital's financial assistance program.
- Maintained performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met while maintaining effective communication with patients, medical office staff, and both internal and external co-workers.
- Notates all actions performed in the applicable host system(s) immediately.
- Performs all other duties, as assigned or requested, while adhering to strict deadlines.
- Obtained outstanding information through professional and timely communication.
- Answered applicants' questions about benefits and claim procedures.
- Assisted applicants with obtaining program support or gaining assistance from outside services.
- Helped applicants understand requirements, application procedures and legal rights.
Supervisor
OBG-YN Associates of Marietta Greater
Atlanta, GA
05.2000 - 04.2022
- Monitored numerous employee activities and assigned tasks to cover demand.
- Took a leadership role in taking our charts from paper to EMR systems.
- Assisted with planning a new office suite and managing the transition.
- Delivered high quality training for new team members.
- Checked patients in and out of their appointments and collected payments.
- Answered phone calls and schedule appointments for patients.
- Assisted with insurance verification and precertification for our patients.
- Executed daily opening and closing procedures to company standard.
- Tracked employee performance to determine areas of strength and improvement.
Education
High school diploma -
Sprayberry High School
Marietta, GASkills
- Insurance benefits verification
- Time management
- Eligibility determination
- Coverage authorizations
- Microsoft Office applications
- Electronic medical records
- Data entry and management
- Customer service excellence
- Coordination and scheduling
- Artiva and Centricity systems
- HMS and Greenway health systems
Middle Initial
M
Timeline
Eligibility Representative
Community Health Systems
04.2022 - Current
Supervisor
OBG-YN Associates of Marietta Greater
05.2000 - 04.2022
High school diploma -
Sprayberry High School
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