Michelle Reiley
Colorado Springs,US
Summary
Goal-oriented Healthcare Consultant effective at dealing with individuals during stressful and confusing situations. Proven expertise in insurance products, administration services and customer needs. Familiar with analyzing documentation, liaising between parties and handling both routine and complex issues each day. Identifies and resolves concerns. Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking entry-level opportunities to expand skills while facilitating company growth. Highly-motivated candidate with the desire to take on new challenges and skills. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills
Overview
13
13
years of professional experience
1
1
Certification
Work History
Enrollment Specialist
Wipro Remote
Colorado Springs, CO
08.2022 - 01.2023
- Verifies enrollment status, makes changes to records, research and resolves enrollment system rejections
- Addresses a variety of enrollment questions and/or concerns received by phone or mail
- May be responsible for billing and delinquency processes for assigned groups
- Ensures accuracy and timeliness of the membership and billing function
- Responds to inquiries concerning enrollment processes
- Maintains enrollment database
- Determines eligibility and applies contract language for each case assigned
- Performs error output resolution for electronic eligibility and processes error discrepancy list
- Performs basic job functions with help from co-workers and managers on non-basic issues.
Healthcare Consultant
Concentrix Remote
Pueblo, CO
01.2022 - 07.2022
- Assisted with regulatory issues
- Consulted with healthcare professionals on business decisions
- Created and implemented organizational policies and procedures
- Oversaw accounting, budgeting, and financial reporting
- Conducted research and investigations into claims, benefits, and authorization
- Followed document protocols to safeguard confidentiality of patient records
- Facilitated communication between patients and various departments and staff
- Helped address client complaints through timely corrective actions and appropriate referrals
- Recommended service improvements to minimize recurring patient issues and complaints
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory, and local, state, and federal guidelines relating to HIPAA, benefits administration, and general liability.
Patient Access Specialist
Merit Health Wesley
Hattiesburg, MS
09.2020 - 09.2021
- Executes full range of receptionist duties, plus recordkeeping, to include but not limited to compiling data for reports, maintaining all patient records, both electronically and paper files
- Miscellaneous clerical duties within ambulatory setting as well as entering, manipulating and/or retrieving information and data from automated systems, such as CHS and Cerner
- File original medical documents in patient records and properly disposing of any additional copies
- Ensures patient completes all necessary forms prior to being seen by provider, serves as primary point of contact for central appointments and referral management offices
- Resolves non-complex patient complaints and problems
- Responsible for administrative support and quality assurance of assigned clinical service area
- Refers urgent messages as well as responding to emergency calls and notifying emergency medical personnel
- Responsible for clerical duties inherent to processing (reception), care and out processing (transition) of outpatients, families/caregivers, and guests
- Collected and validated patient demographics and insurance information
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy
- Obtained signatures for financial responsibility and treatment procedures from patients or guardians
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks
- Prepared patient identification band and completed admissions papers
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered
- Performed patient pre-admission, admission, transfer, and discharge activities
- Contacted insurance companies for patient medical billing operations
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services
- Followed document protocols to safeguard confidentiality of patient records
- Facilitated communication between patients and various departments and staff
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
Administrative Support Specialist
Merit Health Wesley
Hattiesburg, MS
10.2019 - 07.2020
- Answer multiple phone lines and transfer calls as needed
- Follow protocols to safeguard confidential information
- Coordinates and assists with preparation for meetings
- Responsible for patient scheduling, billing, and records
- Create and maintain filing systems electronically and physically
- Order office supplies as needed
- Carry out administrative duties such as filing, typing, copying, binding, record keeping, scanning, etc
- Reply to email, telephone, or face to face inquiries
- Update administrative systems and paperwork to make them more efficient
- Resolve administrative problems
- Receive, sort, and distribute the mail
- Answer telephone calls and pass them on
- Reply to email, telephone, or face to face inquiries
- Handle sensitive information in a confidential manner
- Provider great customer service to visitors and office staff
- Making sure company policy and regulations are followed and are up to date
- Responsible for planning, completing, developing, and organizing work related events.
Sales/Cashier
JCPenney
Hattiesburg, MS
09.2018 - 06.2019
- Assists with inventory, including receiving and stocking merchandise
- Assists customers with finding merchandise and answering questions
- Keeps clientele informed by notifying them of preferred customer sales and future merchandise of potential interest
- Alerts management of potential security issues
- Managing financial transactions
- Processes payments by totaling purchases, processing checks, cash, and store or other credit and debit cards
- Documents sales by creating or updating customer profile records
- Resolves customer issues and concerns
- Promoted customer loyalty and consistent sales by delivering friendly service and knowledgeable assistance
- Answered questions about store policies and addressed customer concerns
- Replenished sales floor merchandise and organized shelves, racks, and bins for optimal appearance
- Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies
- Performed cash, card, and check transactions to complete customer purchases
- Operated cash register to record transactions accurately and efficiently
- Mentored new team members on POS system operation, customer service strategies and sales goals
- Maintained current knowledge of store promotions and highlighted sales to customers
- Used POS system to enter orders, process payments and issue receipts
- Demonstrated product features, answered questions, and redirected objections to highlight positive aspects
- Learned new skills and applied them to daily tasks, improving efficiency and productivity
- Carried out day-to-day duties accurately and efficiently
- Increased sales by 10%.
Dining Facility Attendant
L&S Services
Fort Benning, GA
03.2011 - 05.2014
- Contributed to friendly and professional dining environment by communicating politely and effectively with guests to assess and meet needs
- Took customer orders and relayed to kitchen staff with accuracy, circulating dining room to identify service opportunities
- Set up and break down buffet and other self-service areas, organizing components logically
- Provided attentive service and proactively assessed guest needs
- Monitored dining room inventory and replenished, as necessary
- Learned new skills and applied them to daily tasks, improving efficiency and productivity
- Carried out day-to-day duties accurately and efficiently
- Demonstrated respect, friendliness, and willingness to help wherever needed
- Worked flexible hours; night, weekend, and holiday shifts
- Trained new hires
- Performed duties in accordance with applicable standards, policies, and regulatory guidelines to promote a safe working environment.
Cashier
Captain D's
Phenix City, AL
03.2010 - 03.2011
- Worked flexible schedule and extra shifts to meet business needs
- Helped customers complete purchases, locate items, and join reward programs
- Restocked and organized merchandise in front lanes
- Answered questions about store policies and addressed customer concerns
- Promoted customer loyalty and consistent sales by delivering friendly service and knowledgeable assistance
- Collected and authorized payments of guests
- Worked closely with shift manager to solve problems and handle customer concerns
- Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies
- Maintained secure cash drawers, promptly resolving discrepancies in daily totals
- Mentored new team members on POS system operation, customer service strategies and sales goals
- Demonstrated product features, answered questions, and redirected objections to highlight positive aspects
- Operated cash register to record transactions accurately and efficiently
- Performed cash, card, and check transactions to complete customer purchases
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels
- Increased sales by 8%.
Education
Master of Art - Communication
University of Colorado Colorado Springs
05.2024
Bachelor of Science - Health Administration
American Public University System
12.2021
Skills
- Administrative and Office Support
- Operating Computers and other Office Machines
- Microsoft Office
- Clerical and Filing Support
- Medical Terminology
- Time Management and Prioritization
- Verbal and Written Communication
- Calm and Effective Under Pressure
- Reliable and Hard-Working
- Works Independently
- Office Management
Certification
- Certificate of Achievement of Incident Command Systems, ICS-100, 09/01/20
- Certificate of Achievement of Introduction to Continuity of Operations Planning for Pandemic Influenza, 09/01/20
Timeline
Enrollment Specialist
Wipro Remote
08.2022 - 01.2023
Healthcare Consultant
Concentrix Remote
01.2022 - 07.2022
Patient Access Specialist
Merit Health Wesley
09.2020 - 09.2021
Administrative Support Specialist
Merit Health Wesley
10.2019 - 07.2020
Sales/Cashier
JCPenney
09.2018 - 06.2019
Dining Facility Attendant
L&S Services
03.2011 - 05.2014
Cashier
Captain D's
03.2010 - 03.2011
Master of Art - Communication
University of Colorado Colorado Springs
Bachelor of Science - Health Administration
American Public University System
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