Michelle Ferguson
Jenkintown,PA
Summary
Experienced healthcare professional with over 5 years of combined experience in patient access and insurance verification. Skilled in verifying benefits, obtaining authorizations and referrals, and ensuring accurate patient registration and billing. Proven ability to manage high call volumes, while maintaining a 95% quality rating and delivering exceptional service to patients and providers. Adept at navigating multiple EMR systems and payer portals, coordinating with clinical and billing teams, and maintaining full compliance with HIPAA and organizational standards. Recognized for accuracy, efficiency, and strong communication skills that contribute to streamlined operations and improved patient experiences.
Overview
8
8
years of professional experience
Work History
Patient Access Representative
Jefferson Health
06.2021 - 12.2025
- Verified patient insurance eligibility, benefits, and coverage for medical services across multiple payers.
- Obtained authorizations, pre-certifications, and referrals to ensure timely patient care and claims accuracy.
- Registered patients accurately in the system, maintaining compliance with HIPAA and organizational standards.
- Processed and resolved patient inquiries with empathy and professionalism, maintaining a 95% call quality score.
- Managed a high daily call volume, balancing efficiency with quality service.
- Collaborated with clinical and billing departments to prevent delays in care and reimbursement.
- Contributed to improved departmental accuracy rates through careful data entry and documentation.
- Recognized by management for maintaining consistent productivity and patient satisfaction metrics.
Insurance Verification Specialist
Tower Health
03.2018 - 05.2021
- Verified insurance benefits, coverage limits, and patient liability for medical procedures and visits.
- Secured prior authorizations and referrals to meet payer requirements and reduce claim denials.
- Communicated effectively with patients, providers, and insurance representatives to resolve discrepancies.
- Utilized multiple EMR and payer portals to cross check patient information and update records accurately.
- Maintained an average 95% quality assurance rating and exceeded daily productivity targets.
- Identified and escalated complex insurance issues to ensure timely resolution.
- Assisted in training new team members on insurance verification workflows and quality standards.
- Helped reduce claim rejections by improving front end verification accuracy.
Education
Bachelors of Science in Nursing
Nightingale College
Ogden, UT05-2029
Skills
- Insurance Verification & Eligibility –Experienced in verifying patient coverage, benefits, and co-pays across multiple insurance providers
- Prior Authorizations & Referrals – Skilled in obtaining authorizations and referrals to ensure timely patient service and accurate billing
- Patient Registration & Scheduling – Proficient in entering patient demographics, verifying accuracy, and managing high volume scheduling
- Customer Service & Communication – Strong interpersonal skills with a proven 95% call quality rating; adept at handling sensitive patient information
- Healthcare Systems & Portals – Knowledgeable in Epic, Cerner, Availity, and payer specific verification portals
- Claims & Billing Coordination – Collaborates with billing teams to reduce claim denials and expedite reimbursement
- HIPAA Compliance & Confidentiality – Committed to maintaining patient privacy and regulatory compliance
- Multitasking & Time Management – Manages 50 calls daily while meeting accuracy and productivity goals
- Problem Solving & Attention to Detail – Recognized for identifying discrepancies and ensuring data integrity
Timeline
Patient Access Representative
Jefferson Health
06.2021 - 12.2025
Insurance Verification Specialist
Tower Health
03.2018 - 05.2021
Bachelors of Science in Nursing
Nightingale College