Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michelle Phillips

Montrose,CO

Summary

Detail-oriented proudly offering several years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments. Experienced professional with a strong background in technology-related roles. Proficient in system administration, and technical support. Skilled in problem-solving and optimizing performance. Capable of managing projects and collaborating effectively with teams. Committed to continuous learning and staying current with industry trends to contribute to organizational success. Experienced and dependable general worker with a proven track record of efficiently completing tasks in various settings. Skilled in manual labor, equipment operation, and maintaining a clean and organized workspace. Safety-conscious with a strong work ethic and the ability to adapt to different environments. Ready to contribute to a dynamic team and make a positive impact.

Overview

14
14
years of professional experience

Work History

Prior Authorization Specialist

Montrose Regional Health
Montrose, CO
07.2024 - Current
  • Maintained accurate and up-to-date records of authorization requests and outcomes in electronic health record systems.
  • Coordinated with other departments to obtain additional information needed for prior authorization.
  • Notified ordering providers of denied authorizations.
  • Utilized medical coding knowledge to accurately process and document authorization requests.
  • Evaluated patient eligibility and benefits for requested procedures and medications.
  • Ensured compliance with state and federal regulations pertaining to prior authorizations.
  • Reviewed claims submitted without valid pre-authorization codes and took corrective action when necessary.
  • Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.
  • Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
  • Maintained positive working relationship with fellow staff and management.
  • Collaborated with insurance companies to clarify coverage details and resolve issues related to prior authorization.
  • Provided customer service to patients and healthcare providers, answering questions related to prior authorization and insurance coverage.
  • Communicated authorization decisions, including approvals and denials, to healthcare providers and patients.

Accounts Receivable Manager

Hartman Brothers
Montrose, CO
06.2022 - 07.2024
  • Streamlined accounts receivable processes through automation, enhancing efficiency.
  • Facilitated payment of invoices due by sending bill reminders and contacting clients
  • Monitored delinquent accounts and initiated collection efforts as needed.
  • Analyzed customer accounts to identify and resolve discrepancies.
  • Initiated legal or collection agency intervention for severely overdue accounts.
  • Prepared monthly aging reports for review by management.
  • Performed day-to-day financial transactions, including verifying, classifying, computing, posting and recording accounts receivables' data.
  • Utilized daily audit information to update aging reports.
  • Participated in strategic planning to improve overall financial health of the organization.
  • Reconciled daily cash receipts and applied payments to the appropriate accounts.
  • Coordinated with the accounting department to post payments and adjustments accurately.
  • Coordinated preparation of external audit materials and external financial reporting.
  • Created financial management mechanisms to minimize financial risk to business.
  • Implemented new procedures within the Accounts Receivable department to improve efficiency.
  • Negotiated payment plans with delinquent accounts to maximize recovery rates.
  • Maintained updated customer records, including contact information and payment terms.
  • Researched disputed invoice items for resolution of payment delays.
  • Maintained accurate records of all accounts receivable transactions.
  • Ensured compliance with internal controls and accounting standards in receivables management.
  • Ensured compliance with federal, state, and local regulations related to accounts receivable processes.
  • Developed and maintained aging report to monitor and analyze outstanding receivables.
  • Drafted correspondence such as dunning letters or demand notices when necessary.
  • Conducted monthly reconciliation of the accounts receivable ledger to ensure accuracy.
  • Followed up with customers via phone, email, or mail regarding outstanding invoices.
  • Created detailed reports on overdue accounts for internal use and external reporting requirements.
  • Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
  • Generated monthly statements for clients outlining their current balances due.
  • Completed daily accounts receivable ledger reconciliations.

Referral Coordinator/Travel Coordinator/Prior Authorization Specialist

Seldovia Village Tribe
Homer, AK
07.2020 - 05.2022
  • Scheduled patients according to availability, urgency and insurance authorization guidelines.
  • Conducted outreach to community providers for referrals and resources.
  • Monitored referral outcomes, reporting on trends and areas for improvement to healthcare management teams.
  • Conducted follow-up with patients and healthcare providers to ensure satisfaction and address any concerns post-referral.
  • Communicated with patients with compassion while keeping medical information private.
  • Assisted patients with navigation of complex healthcare systems, providing guidance on insurance and specialist services.
  • Maintained accurate records of all referrals, including contact information and follow-up activities.
  • Performed additional office duties, handling patient service inquiries and receiving payments.
  • Educated patients on the referral process, including expected timelines and preparation for specialist visits.
  • Coordinated work activities and scheduling of medical, nursing and physical plant staff.
  • Collaborated with multi-disciplinary staff to improve overall patient care and response times.
  • Provided excellent customer service to both internal and external customers.
  • Resolved issues arising during the referral process, including insurance denials and appointment scheduling conflicts.
  • Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
  • Maintained accurate and up-to-date patient records, including referral status and follow-up information.
  • Facilitated communication between primary care physicians, specialists, and patients to ensure a smooth referral process.
  • Adhered to HIPAA regulations when handling confidential patient information.
  • Developed relationships with key stakeholders within the healthcare system to facilitate effective referrals.
  • Ensured compliance with healthcare regulations and policies related to patient referrals and data privacy.
  • Communicated regularly with patients regarding their care plans following a referral.
  • Maintained communication and transparency with governing boards, department heads and medical staff.
  • Coordinated with healthcare providers to verify patient insurance coverage and obtain necessary pre-authorizations for treatments.
  • Coordinated with external agencies to ensure timely processing of referrals.
  • Utilized various healthcare IT systems to schedule appointments and communicate with medical professionals and patients.
  • Resolved conflicts between referring physicians and receiving providers.
  • Monitored patient progress throughout the referral process.
  • Reviewed medical records to determine if additional services are needed prior to making a referral.
  • Maintained awareness of government regulations, health insurance changes and financing options.
  • Ensured compliance with applicable laws and regulations regarding referrals.
  • Worked closely with billing departments to ensure accurate coding and billing for referred services.
  • Performed data entry related to referrals into electronic health record systems.
  • Verified documents and associated records to catch and resolve discrepancies.
  • Compiled, recorded, or coded data from referrals or surveys using computer or specified form.
  • Developed and managed travel itineraries for business trips, ensuring all necessary arrangements were made in advance.
  • Maintained up-to-date knowledge of travel advisories, visa requirements, and vaccination policies.
  • Coordinated ground transportation to and from accommodations for clients.
  • Provided exceptional customer service, resolving any travel-related issues promptly.
  • Built and maintained strong relationships with vendors and suppliers in the travel industry.
  • Detected and eliminated safety hazards during travel.
  • Interviewed and qualified clients to determine travel and lodging needs and recommended points of interest to maximize travel experiences.
  • Booked transportation and hotel reservations using computer or telephone.
  • Developed personalized travel itineraries based on clients' preferences and budget.

Intake Coordinator/Medical Biller

Hartman Brothers
Montrose, CO
10.2018 - 06.2020
  • Maintained accurate and up-to-date records of client interactions and services provided.
  • Conducted initial risk assessments to identify any immediate concerns or needs for intervention.
  • Assisted in developing policies and procedures related to intake processes.
  • Coordinated with external agencies and community partners to facilitate referrals and access to services.
  • Created individualized service plans for each client based on their unique needs and goals.
  • Developed strategies to assist clients in overcoming barriers that impede successful outcomes.
  • Adhered to confidentiality guidelines when handling sensitive information about clients.
  • Supported the development and implementation of policies and procedures to enhance service delivery and client care.
  • Managed confidential client data in compliance with HIPAA and other relevant regulations.
  • Assisted in determining appropriate referrals for clients to other community agencies or programs.
  • Maintained accurate records of client intakes in electronic database system.
  • Coordinated the intake process, ensuring all required documentation was collected and processed.
  • Maintained updated knowledge through continuing education and advanced training.
  • Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
  • Worked effectively in team environments to make the workplace more productive.
  • Recognized by management for providing exceptional customer service.
  • Collaborated closely with team members to achieve project objectives and meet deadlines.
  • Monitored past due accounts and pursued collections on outstanding invoices.
  • Reconciled codes against services rendered.
  • Maintained historical records by microfilming and filing documents.
  • Reviewed legal claims for accuracy and issues.
  • Enforced compliance with organizational policies and federal requirements regarding confidentiality.
  • Submitted electronic claims to various insurance carriers.
  • Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
  • Reviewed claims for coding accuracy.
  • Checked claims coding for accuracy with ICD-10 standards.
  • Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
  • Ensured compliance with HIPAA guidelines when handling confidential patient information.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Maintained accurate patient data in electronic health records system.
  • Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Organized information for past-due accounts and transferred to collection agency.
  • Compiled and processed data for billing purposes utilizing billing software programs.
  • Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
  • Reviewed engine assigned codes and modifiers to update and verify accuracy.
  • Submitted appeals using provider portals and phone communication.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.

Office Manager

Volunteers Of America Colorado Branch
Montrose, CO
08.2016 - 04.2018
  • Assigned work and monitored performance of project personnel.
  • Trained and mentored administrative staff members in company policies, daily task execution and industry best practices.
  • Implemented and maintained company protocols to facilitate smooth daily activities.
  • Assisted in recruiting, onboarding and training new employees.
  • Provided administrative support to management team including preparing reports and presentations.
  • Maintained impeccable office organization to support efficiency, professionalism and performance objectives.
  • Reviewed files and records to obtain information and respond to requests.
  • Implemented quality control measures to uphold company standards.
  • Managed office budget to handle inventory, postage and vendor services.
  • Resolved customer inquiries and complaints requiring management-level escalation.
  • Created spreadsheets in Excel to track data such as vacation requests, sick days .
  • Assisted in developing budgets for departmental expenses.
  • Administered payroll and maintained proper documentation of employee personnel.
  • Tracked invoices and payments to ensure accuracy of accounts receivable and payable information.
  • Assisted with the preparation of budgets, forecasts and financial statements.
  • Recruited and trained new employees to meet job requirements.
  • Coordinated meetings, conferences, travel arrangements and department activities.
  • Ordered supplies and equipment to maintain adequate inventory levels.
  • Evaluated individual and team business performance and identified opportunities for improvement.
  • Coded and entered daily invoices with in-house accounting software.
  • Delegated work to staff, setting priorities and goals.
  • Used judgment and initiative in handling confidential matters and requests.
  • Resolved customer inquiries in a timely manner while maintaining positive relationships with clients.
  • Ensured compliance with applicable laws regarding employment practices.
  • Held regular one-on-one meetings with employees to review performance and priorities and provide feedback.
  • Responded to customer inquiries via phone or email in a professional manner.
  • Planned and delivered training sessions to improve employee effectiveness and address areas of weakness.
  • Maintained confidential records relating to personnel matters.
  • Maintained filing system for records, correspondence and other documents.
  • Supervised staff members, organized schedules and delegated tasks.
  • Developed and implemented office policies and procedures.
  • Organized team activities to build camaraderie and foster pleasant workplace culture.
  • Monitored payments due from clients and promptly contacted clients with past due payments.
  • Answered phone calls, responded to emails, routed mail and coordinated courier services.
  • Managed, scheduled and coordinated office functions and activities for employees.
  • Mediated conflicts between employees and facilitated effective resolutions to disputes.
  • Provided training to new hires on office policies and procedures.
  • Remained calm and professional in stressful circumstances and effectively diffused tense situations.
  • Organized company events including holiday parties, team building activities .
  • Interviewed prospective employees and provided input to HR on hiring decisions.
  • Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
  • Automated office operations for managing client correspondence, payment schedules and data communications.
  • Processed payroll accurately ensuring all employees were paid on time.
  • Planned and led team meetings to review business results and communicate new and ongoing priorities.
  • Performed general bookkeeping duties such as reconciling bank statements and creating journal entries.
  • Managed time effectively to ensure tasks were completed on schedule and deadlines were met.

Office Manager

Suburban Propane
Homer, AK
09.2014 - 01.2016
  • Assigned work and monitored performance of project personnel.
  • Trained and mentored administrative staff members in company policies, daily task execution and industry best practices.
  • Implemented and maintained company protocols to facilitate smooth daily activities.
  • Monitored inventory levels and placed orders when needed.
  • Provided administrative support to management team including preparing reports and presentations.
  • Maintained impeccable office organization to support efficiency, professionalism and performance objectives.
  • Implemented quality control measures to uphold company standards.
  • Managed office budget to handle inventory, postage and vendor services.
  • Reviewed completed work to verify consistency, quality, and conformance.
  • Created spreadsheets in Excel to track data such as vacation requests, sick days .
  • Tracked invoices and payments to ensure accuracy of accounts receivable and payable information.
  • Elevated customer satisfaction ratings by promptly resolving client and case issues.
  • Ordered supplies and equipment to maintain adequate inventory levels.
  • Coordinated meetings, conferences, travel arrangements and department activities.
  • Oversaw receiving and organizing correspondence, answering and forwarding calls and creating business letters and records.
  • Coded and entered daily invoices with in-house accounting software.
  • Delegated work to staff, setting priorities and goals.
  • Used judgment and initiative in handling confidential matters and requests.
  • Resolved customer inquiries in a timely manner while maintaining positive relationships with clients.
  • Ensured compliance with applicable laws regarding employment practices.
  • Handled scheduling and managed timely and effective allocation of resources and calendars.
  • Responded to customer inquiries via phone or email in a professional manner.
  • Coordinated office activities and operations to secure efficiency and compliance with company policies.
  • Maintained filing system for records, correspondence and other documents.
  • Supervised staff members, organized schedules and delegated tasks.
  • Answered phone calls, responded to emails, routed mail and coordinated courier services.
  • Monitored payments due from clients and promptly contacted clients with past due payments.
  • Interpreted and communicated work procedures and company policies to staff.
  • Managed, scheduled and coordinated office functions and activities for employees.
  • Provided training to new hires on office policies and procedures.
  • Remained calm and professional in stressful circumstances and effectively diffused tense situations.
  • Managed office inventory and placed new supply orders.
  • Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
  • Automated office operations for managing client correspondence, payment schedules and data communications.
  • Performed general bookkeeping duties such as reconciling bank statements and creating journal entries.
  • Developed effective communication strategies between departments within the organization.
  • Completed day-to-day duties accurately and efficiently.
  • Operated a variety of machinery and tools safely and efficiently.
  • Provided support and guidance to colleagues to maintain a collaborative work environment.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
  • Assisted with customer requests and answered questions to improve satisfaction.
  • Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.

Residential Manager

Community Options Inc
Montrose, CO
10.2010 - 02.2013
  • Performed administrative tasks such as scheduling appointments or responding emails promptly.
  • Maintained updated resident records and coordinate move-in and move-out logistics.
  • Assisted in the preparation of budgets for residential buildings; monitored expenditures against budget allocations.
  • Prepared monthly reports summarizing the financial performance of each property unit.
  • Participated in hiring process by interviewing potential candidates for vacant positions in the organization.
  • Supervised a team of staff members responsible for cleaning, landscaping, repairs, security, and tenant relations.
  • Trained and coached staff to consistently meet residents' needs with caring, knowledgeable and safe support.
  • Recommended clarifications and changes in program policies to director of property management.
  • Planned, scheduled and coordinated general maintenance or repairs for commercial or residential properties.
  • Met with committees to discuss and resolve legal and environmental issues.
  • Developed and implemented policies and procedures to ensure compliance with local housing regulations.
  • Enhanced event space quality by partnering with construction crews and contractors to complete maintenance and repairs.
  • Established a customer service program to ensure tenants receive prompt response to requests and complaints.
  • Organized events such as community meetings or social activities to foster strong relationships among residents.
  • Conducted regular inspections of residential buildings and common areas to identify health, safety, and maintenance issues.
  • Developed, implemented and monitored patient and resident care, performance improvement programs, policies, and procedures.
  • Coordinated the acquisition of materials, supplies, and services necessary for building repair and upkeep.
  • Coordinated adequate coverage for resident needs with organized staff schedules and assignments.
  • Answered calls and responded to inquiries from various parties using strong active listening and open-ended questioning skills to resolve problems.
  • Responded quickly to emergency situations within residential buildings or on grounds; coordinated appropriate follow-up action.
  • Monitored employees' compliance with individuals' support plans and medical protocols.
  • Investigated incidents involving tenants or visitors; took appropriate disciplinary actions when needed.
  • Adhered strictly to safety protocols while performing duties; ensured that proper safety measures were taken at all times.
  • Resolved conflicts between tenants in an effective manner through active listening techniques.
  • Kept building up-to-date with current fire and health code standards.
  • Prepared detailed budgets and financial reports for properties.
  • Ensured that all legal documents are properly filed according to established guidelines.
  • Drafted monthly manager's report to report data and events to board members and management.
  • Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
  • Provided support and guidance to colleagues to maintain a collaborative work environment.
  • Managed inventory and supplies to ensure materials were available when needed.
  • Maintained updated knowledge through continuing education and advanced training.
  • Updated and maintained databases with current information.
  • Recognized by management for providing exceptional customer service.
  • Collaborated closely with team members to achieve project objectives and meet deadlines.
  • Worked effectively in team environments to make the workplace more productive.
  • Exceeded customer satisfaction by finding creative solutions to problems.

Education

Diploma - Medical Office Management

Colorado College of Medical And Dental Career's
Denver, CO
04-1990

Skills

  • Authorizations
  • Insurance information oversight
  • Physician order verification
  • Patient scheduling
  • Patient confidentiality compliance
  • Critical thinking
  • Medical appeals handling
  • Practitioner order verification
  • Process improvement strategies
  • Patient referrals
  • Precertification requirements
  • Provider relations
  • Performance metrics analysis
  • Quality assurance practices
  • Prior authorization process
  • Utilization review experience
  • Workflow management
  • Private insurance
  • Healthcare regulations
  • Prescription coordination
  • Effective communication skills
  • Medical terminology knowledge
  • HIPAA compliance
  • Data entry
  • Issue research
  • Proficiency in [software]
  • Retro-authorizations
  • Medical terminology
  • Clinical documentation improvement
  • Medical billing procedures
  • Claims processing experience
  • Insurance procedures
  • Billing procedures
  • Claim research
  • Medical office procedures
  • Insurance verification
  • Medical coding
  • Electronic health records proficiency
  • Professionalism and ethics
  • Benefit coverage
  • Records maintenance

Timeline

Prior Authorization Specialist

Montrose Regional Health
07.2024 - Current

Accounts Receivable Manager

Hartman Brothers
06.2022 - 07.2024

Referral Coordinator/Travel Coordinator/Prior Authorization Specialist

Seldovia Village Tribe
07.2020 - 05.2022

Intake Coordinator/Medical Biller

Hartman Brothers
10.2018 - 06.2020

Office Manager

Volunteers Of America Colorado Branch
08.2016 - 04.2018

Office Manager

Suburban Propane
09.2014 - 01.2016

Residential Manager

Community Options Inc
10.2010 - 02.2013

Diploma - Medical Office Management

Colorado College of Medical And Dental Career's

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Michelle Phillips