Monica L. White
Houston,TX
Summary
Goal oriented seeking to obtain a position that will allow career advancement and give the opportunity to utilize my technical skills, while allowing professional, administrative, and customer service growth.
Healthcare professional with extensive experience in patient access roles, ensuring accurate data management. Proven ability to collaborate effectively with teams and adapt to dynamic healthcare environments. Known for excellent communication skills and strong attention to detail.
Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.
Overview
17
17
years of professional experience
Work History
Patient Access Representative III, Appeal Coordinator I
Memorial Hermann Hospital TIRR
07.2009 - 08.2024
- Responsible for assigning incoming cases to verification team while motivating teammates to meet department authorization goal with 99% accuracy
- Analyze large medical and financial data to determine medical necessity and compliance
- Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
- Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor and obtaining necessary signatures
- Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility
- Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes
- Responsible for initiating and obtaining financial LOA's (Letter of agreement) requests for Workman Compensation and non-network providers.
- Monitors, reviews and resolves patient account issues on assigned reports
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Communicates in an effective and professional manner with Physicians, ancillary departments, nursing units, physicians' office staff, insurance companies, as well as patients and their families
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
- Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
- Enhanced departmental collaboration by regularly liaising with medical, nursing, and administrative staff on pertinent patient matters.
- Maintained high standards of confidentiality and privacy, strictly adhering to HIPAA regulations.
- Contributed to revenue cycle improvements by identifying and rectifying billing discrepancies.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff
- Responsible for reviewing denial reasoning for non-payment of rehab services provided by verifying the correct CPT and ICD 10 codes that were submitted when authorization was obtained.
- Responsible for reviewing and submitting the required clinical documentation and medical necessity to support the appeal review in order to obtain payment.
- Responsible for assisting patients/or responsible parties with expedited appeal requests for denied acute inpatient rehab services for traumatic brain and spinal cord injuries as well as the DOC (disorder of consciousness) program provided via TIRR therapists and physicians within 72hrs timeframes.
- Conducted the expedited appeal requests to commercial insurance payors, Medicare, Medicare Replacement plans, 3rd level requests via Maximus, Texas Medicaid and CHIP programs. Also, obtained AOR forms from denied Medicare replacements patients and acted as designated representative during denial process.
Assistant Bar Manager, Bartender
Razzoo's Cajun Kitchen
10.2007 - 09.2016
- Cultivated a loyal customer base by delivering exceptional service experiences, resolving complaints promptly, and soliciting feedback for continuous improvement efforts.
- Served high customer volumes during special events, nights, and weekends.
- Managed cash handling duties responsibly, ensuring accurate accounting at the end of each shift.
- Performed opening and closing duties, printing sales reports, setting up for incoming shift, preparing cash drawers, and taking inventory.
- Maintained a clean and organized workspace, ensuring compliance with health and safety regulations.
- Followed alcohol awareness procedures for preventing excessive guest intoxication.
- Trained new bartenders on drink preparation, product promotion, garnish preparation, and sanitation protocol.
- Maintained extensive knowledge of cocktail recipes and preparation techniques, ensuring high-quality beverage menu.
- Successfully resolved customer complaints, demonstrating strong conflict resolution skills and commitment to client satisfaction.
- Ensured accurate cash handling procedures were followed consistently throughout each shift to maintain financial accountability.
- Adhered to state laws regarding alcoholic beverage services and customer regulations.
- Managed budgets effectively, ensuring optimal financial performance while investing in necessary resources for business growth.
- Reduced operational costs through comprehensive process improvement initiatives and resource management.
- Achieved significant cost savings by renegotiating contracts with key vendors, without compromising service quality.
- Implemented customer feedback mechanisms to gather insights, using this information to guide strategic planning and decision-making.
- Established team priorities, maintained schedules and monitored performance.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
Patient Access Representative IV
MD Anderson UT Cancer Center
11.2013 - 12.2014
- Consistently and accurately utilizes medical acceptance criteria to screen and schedule appointment for a new patient in a way to ensure optimal efficiency in clinic operations
- Provides financial counseling option to patient including cost estimates payment plans discounts and supplemental financial assistance utilizing medical overrides and account review as appropriate
- Collects complete and accurate financial data during intake process to ensure appropriate financial screening of new patient and verifies data during new patient registration to ensure compliance with required forms and consents
- Uses technical expertise to obtain insurance information verify benefits and secure authorizations
- Uses excellent oral communication and listening skills to communicate with patient referral source, MDACC physician and MDACC clinical staff regarding obstacles to access or financial clearance
- Responds to voice mail and my MD Anderson messages within one business day and answers phone call in a timely manner
- Completely and accurately documents communication with payers, patient and the treatment team
- Responsible for approving completed Charity applications for unfunded patients that included review of bank statements, IRS tax returns and property taxes
Education
Associate Degree - Applied Science
Austin Community College
05.2005
High School Diploma -
Stroman High School
05.1994
Skills
- Insurance Verification
- Financial Clearance
- Accounts Reconciliations
- Data Entry
- Risk Management
- 10 Key by Touch
- Accounts Management
- Information Analysis
- 50 WPM
- HIPAA Compliance
- Financial Procedures Adherence
- Insurance company knowledgeable
Timeline
Patient Access Representative IV
MD Anderson UT Cancer Center
11.2013 - 12.2014
Patient Access Representative III, Appeal Coordinator I
Memorial Hermann Hospital TIRR
07.2009 - 08.2024
Assistant Bar Manager, Bartender
Razzoo's Cajun Kitchen
10.2007 - 09.2016
High School Diploma -
Stroman High School
Associate Degree - Applied Science
Austin Community College
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