Monique Kelly RHIT
Pittsburgh,PA
Summary
Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills.
Overview
8
8
years of professional experience
Work History
Clinical Access Coordinator
Alleghany Health Network
10.2023 - Current
- Improved patient access by streamlining registration processes and reducing wait times.
- Enhanced patient satisfaction with efficient scheduling of appointments and followups.
- Coordinated medical records management, ensuring timely and accurate documentation for effective patient care.
- Maintained a comprehensive database of patient information to facilitate seamless communication between departments.
- Optimized facility utilization by effectively managing room assignments and resource allocation.
- Collaborated with clinical teams to ensure appropriate patient placement based on acuity and service requirements.
- Provided exceptional customer service to patients, families, and referring providers, fostering positive relationships.
- Conducted regular audits of appointment schedules to identify areas for improved efficiency or accuracy in data entry.
- Worked closely with insurance companies to verify coverage details and obtain necessary authorizations for services rendered.
Administrative Assistant
Ginkgo BioWorks (Pittsburgh Public Schools)
11.2021 - 06.2023
- Obtained informed consent of research subjects and their guardians for Covid-19 testing
- Downloaded paper and electronic medical records then upload to the company server using Microsoft office and excel
- Screened potential subjects to determine their suitability as study participants
- Protected the security of medical records to ensure that confidentiality is maintained
- Reviewed records for completeness, accuracy, and compliance with Covid-19 regulations
- Interviewed staff to identify problems relating to care
- Maintained knowledge of community services and resources available to staff
- Referred staff to appropriate health care services and resources
- Collected specimens such as blood samples, as required by research project.
Administrative Assistant
Oxford Staffing Services (Fed Ex)
01.2020 - 11.2021
- Negotiated and arranged transport of goods with shipping freight companies
- Determined method of shipment and prepared bills of lading, invoices, and other shipping documents
- Tracked delivery progress of shipments
- Contacted vendors and claims adjustment departments to resolve shipment problems and contact service depots to arrange for repairs.
Administrative Assistant
Housing Authority of Pittsburgh
10.2019 - 01.2020
- Interpreted and explained information such as eligibility requirements, application details, and applicants' legal rights
- Interviewed benefits recipients at specified intervals to certify their eligibility for continuing benefits
- Keep records of assigned cases, scheduled Inspections of potential residences
- Answered applicants' questions about benefits and procedures
- Interviewed and investigated applicants for public assistance to gather information pertinent to their applications.
Insurance Verification Specialist
Alliance Rx Walgreens Prime
06.2018 - 03.2019
- Made outbound calls to Payers and Pharmacy Benefit Manager in order to verify patient insurance coverage and identify available Medical and Pharmacy benefits
- Communicated case details to appropriate internal or external parties once benefit verification is complete
- Identified any payer coverage restrictions and potential mechanisms for quickly accessing therapy
- Ability to effectively contribute alone or in small work groups
- Effectively met production and time completion goals
- Accurately documented payer Prior Authorization and Appeals protocols
- Participated in special projects and performed additional duties as required
- Maintained repository of payer or brand specific coverage information
- Participated in training and process improvement initiatives.
Reimbursement Specialist
AmerisourceBergen
10.2017 - 06.2018
- Worked rejected real-time claims for all pharmacies supported by the program
- Worked with pharmacies to process claims and ensure timely dispensing of medications
- Worked with facility staff and program offering documents to gather pertinent information needed to secure successful adjudication
- Called insurance plans to follow-up on submitted prior authorizations, when applicable
- Communicated to the staff and then escalate to the Program Manager any unresolved issues in claims processing
- Proactively monitor daily claims to identify potential claims issues before prescription abandonment
- Follow all applicable government regulations including HIPAA
- Display behavior which exemplifies employee code of conduct guidelines.
Medical Records Technician
CIOX Health
06.2016 - 10.2017
- Protected the security of medical records to ensure that confidentiality is maintained
- Reviewed records for completeness, accuracy, and compliance with regulations
- Interviewed patients or their representatives to identify problems relating to care
- Maintained knowledge of community services and resources available to patients
- Referred patients to appropriate health care services or resources.
Education
Health Information Technology- A.S. - Medical Coding
CCAC Allegheny Campus
Pittsburgh, PA05.2024
Associate of Science - Medical Insurance Billing
Western School of Health
Pittsburgh, PA05.2006
High School Diploma -
Westinghouse High School
Pittsburgh, PA06.2003
Skills
- HIPAA Compliance
- Coding Error Resolution
- Anatomy & Physiology Knowledge
- MS-DRG
- Insurance Verification
- Microsoft Office mastery
- EpicCare, Epic Cadence,
- Medical Terminology
- Medical Insurance Billing
- EMR
- Insurance Authorizations
- Insurance coding (ICD-9, ICD-10CM, ICD-10PCS, HCPCS and CPT)
- Clinical Documentation
- Claims Processing
- Inpatient records Coding
- Outpatient records Coding
- 3M Encoder
Timeline
Clinical Access Coordinator
Alleghany Health Network
10.2023 - Current
Administrative Assistant
Ginkgo BioWorks (Pittsburgh Public Schools)
11.2021 - 06.2023
Administrative Assistant
Oxford Staffing Services (Fed Ex)
01.2020 - 11.2021
Administrative Assistant
Housing Authority of Pittsburgh
10.2019 - 01.2020
Insurance Verification Specialist
Alliance Rx Walgreens Prime
06.2018 - 03.2019
Reimbursement Specialist
AmerisourceBergen
10.2017 - 06.2018
Medical Records Technician
CIOX Health
06.2016 - 10.2017
Health Information Technology- A.S. - Medical Coding
CCAC Allegheny Campus
Associate of Science - Medical Insurance Billing
Western School of Health
High School Diploma -
Westinghouse High School
Similar Profiles
Angela GuinyardAngela Guinyard
Patient Biller at Alleghany Health NetworkPatient Biller at Alleghany Health Network
Destinee ButronDestinee Butron
Clinical Operations Coordinator at Alleghany HealthClinical Operations Coordinator at Alleghany Health
Melinda ThomasMelinda Thomas
Certified Nursing Assistant at Alleghany Health And Rehabilitation CenterCertified Nursing Assistant at Alleghany Health And Rehabilitation Center