Monique Sykes
Los Angeles,California
Summary
Monique is a dedicated and enthusiastic Referral Specialist with over 20 years of experience in the medical industry. She is a highly organized and an effective leader with a strong history of medical office operations and fulfillment of role responsibilities at UCLA and Providence St. John and Cedars Sinai Medical Center. Monique is skilled at providing patient outreach and communications with an emphasis on troubleshooting patient concerns. She is experienced in applicable computer software including: EPIC, Office Ally, Meditech, and Next Gen.
Overview
17
17
years of professional experience
Work History
Patient Service Representative II
Cedars Sinai Medical Center
08.2022 - Current
- Processing Patient Referrals through HMO, PPO, Medicare, Medi-Cal insurances
- Insurance verification via Availity or Passport
- Data Entry of all medical documents
- Submission of referral denials via Appeals to HMO, PPO, Medicare Medi-Cal insurances
- Heavy Inbound Calls
- Appointment and procedure Scheduling For surgical center treatments
Legal Intake Coordinator
McNichols & McNicholas Law Group
04.2022 - 08.2022
- Greeting Clients
- Collecting Information and Recording Information
- Detailing the reason for the call
- The details of ongoing or potential cases
- Questions about the legal process
- Directing Clients To Appropriate Departments
- Attorney assigned to your case
- Providing intake forms
- Setting appointments
- Answering questions related to how long the case will take, how much should I expect to spend on my case, which forms I should fill out
- Excel Spreadsheets with specific client information related to potential law suit
Patient Care Representative II
Providence Medical Care Foundation
01.2022 - 04.2022
- Company Overview: Contracted Position With Kelly Services
- Review and resubmit insurance claims to HMO, PPO Medicare, Medi-Cal insurances via EPIC
- Verification Of Referrals To Providence Specialist Via EPIC
- Intermediate Data Entry
- Heavy Inbound Calls From Outside Insurance Companies
- Submission Of Medical Records TO Insurance Companies
- Insurance Verification via Availity
- Daily Spreadsheet of approvals, denials and pending referrals
- Contracted Position With Kelly Services
Patient Service Representative II
Cedars-Sinai Pain Center
04.2021 - 12.2021
- Company Overview: Contracted Position With Aya Healthcare
- Intermediate data entry
- Insurance verification through Availity
- Appointment Scheduling for pain procedures
- Referral Submission of 20-30 referrals through the work que
- Daily Contact With Insurance Companies regarding the status of referrals HMO PPO Medicare, Medi-Cal
- Manually or Electronically faxing clinical documentation for approval
- Daily check of Emails
- Daily check of in baskets
- Intermediate Microsoft Word
- Daily Excel Spreadsheets OF Referrals
- Collecting Cash and Credit Card Co-Payments
- Submission of Appeals to HMO & PPO based on denial of referrals
- Contracted Position With Aya Healthcare
Administrative Assistant ll
UCLA Health
01.2021 - 03.2021
- Company Overview: Contracted position with Axelon
- Expert in My UCLA portal and access to medical records
- Maintain complete confidentiality when using of Care Connect (EPIC) systems
- Performed a high degree of accuracy administrative support including collecting patient payments, performing insurance verification, scheduling follow-up appointments and/or ancillary testing, obtaining records/authorizations, and performing encounter in patient registration systems
- Effectively blend management skills with technical expertise with intermediate data entry, copayments and balances
- Procedure Scheduling For In-patient and out-patient procedures
- Contracted position with Axelon
Patient Care & Urgent Care Representative II
Providence St. Johns Medical Center
08.2019 - 11.2020
- Completed patient check-in process including greeting patients, managing the patient sign-in sheet, obtaining accurate and current patient contact and insurance information, initialing the patient registration in our EPIC system, confirm completeness of insurance information, and collecting patient co-payments
- Provided after-hours support to urgent care physicians
- Facilitated check-in, and check out of patient services, collected co-payments, and verified medical insurance, for urgent surgeries and acutely ill walk-in patients
- Managed switchboard, answering all calls from patients and outside sources directing questions and messages to appropriate departments in a timely manner and data entry
Case Management Coordinator
California Rehab Institute
11.2018 - 08.2019
- Processed patient imaging referrals for Cedars Sinai and UCLA
- Processed patient referrals for specialist appointments with Cedars Sinai & UCLA
- Provided patient transportation to and from medical appointments
- Research for patients stays at skilled nursing facilities based on the financial needs of the patient
- Submission for patient referrals for skilled nursing facilities
- Utilized microsoft word for weekly case management meetings
- Utilized Excel for weekly case management meetings
- Daily spread sheet of patient documents and advance directives
Customer Service Representative
Conifer Health Solutions
08.2017 - 09.2018
- Determined reasons for customer service calls and assisted the caller with queries and concerns regarding hospital accounts related to balance due on accounts, insurance claim processing, refunds due to patients or insurance companies, disputes with the hospital, attorney calls regarding billing records, verifying insurance eligibility, assist patients with financial assistance and submitted patient request for itemized statements
- Maintained customers and client accounts through accurate, timely, relevant, and quality work efforts of all inventory assigned to the self-pay billing revenue cycle and call center
- Maintained broad knowledge of products, pricing, promotions, procedures, and other important issues through management communications, meetings, client focus groups, and formal training
Call Center Representative & Patient Referral Coordinator
UCLA Health
01.2015 - 01.2017
- Established a close working relationship with diagnostic imaging centers to facilitate urgent scheduling of MRI's and CT Scan for high risk patients
- Expedited 100 patient referrals daily to specialty offices, faxed medical records, answered patient and specialty office calls and completed referral requests
- Utilizing ICD-10 codes & CPT Codes with proficiency relating to medical terminology and strong healthcare background
Front Office Secretary
Burbank Pediatrics
11.2013 - 12.2014
- Scheduling patient appointments, collecting daily co-payments, insurance verification, pharmacy calls and documentation, data entry, EMR, managing heavy phone lines, posting billing payments
- Provided general office and clerical support to assigned out-patient/medical office
- Completed medical record release requests and schedules/confirms patient appointments
- Achieved and maintained a level of productivity which met and exceeded the standards established for the facility by the organization
- Prepared lab slips and tube labels for routine and non-routine blood work
Front Office Assistant
Dr. Ian Taras Gynecology
06.2008 - 09.2013
- Maintained and updated filing, mailing and database systems, both manually and on computer
- Reviewed files, records, and other documents to obtain information to effectively respond to company and customer requests
- Instrumental in preparation of physician's communication with patients
- Scheduled appointments checked patients in and out, collected patient payments
- Submitted diagnosis codes to insurance companies for payment
Skills
- Leader
- Team Player
- Data entry
- 40 WPM
- EMR & Next Gen
- Care Connect
- EPIC
- Office Ally
- Medisoft Next Gen
- Availty & Passport
- Microsoft Word
- Excel
- Customer service
- Follow-up skills
- Computer skills
- Email communication
- Client advocacy
- Problem resolution
- Problem-solving skills
- Reception duties
- Listening skills
- HIPAA compliance
- Multi-line phone systems
- Administrative support
- Call center experience
- Complaint resolution
- Customer support
- Follow-up coordination
- Maintaining records
- Administrative skills
- Maintaining confidentiality
- Patient-focused care
- Patient scheduling
- Claims processing
- Insurance verification
- Complaint handling
- Customer satisfaction measurement
- Call center customer service
- File management
- Insurance verifying
- Patient chart maintenance
- Microsoft Excel
- Typing speed
- Patient communication
- Professional telephone demeanor
- Resolving issues
- Referral tracking
- Basic accounting
- Appointment setting
- Appointment scheduling
- Multi-line phone operations
- Care planning
- File organization
- Dispute resolution
- Call center operations
- Inbound phone calls
- Patient confidentiality
- File maintenance
- Meeting coordination
- Microsoft outlook
- Documentation
- Confidentiality
- Call management
- Patient charting
- Patient management
- Customer and client relations
- EMR management
- Word processing
- Customer communications
- Microsoft office
- Patient information verification
- Computer proficiency
- Escalation management
- Follow-up care coordination
- Scheduling appointments
- Paperwork processing
- Insurance coverage verification
- Answering questions
- Telephone and email etiquette
- Medical terminology
- Written and verbal communication
- Gathering information
- Patient relations
- Clerical support
- Detail-oriented
- Customer relationship management (CRM)
- Calm disposition
- Critical thinking
- Handling complaints
- De-escalation techniques
- Customer service optimization
- Client needs assessments
- Medical insurance
- Strong problem solver
- Inbound phone call management
- Workflow management
- Presentation creation
- Office administration
Timeline
Patient Service Representative II
Cedars Sinai Medical Center
08.2022 - Current
Legal Intake Coordinator
McNichols & McNicholas Law Group
04.2022 - 08.2022
Patient Care Representative II
Providence Medical Care Foundation
01.2022 - 04.2022
Patient Service Representative II
Cedars-Sinai Pain Center
04.2021 - 12.2021
Administrative Assistant ll
UCLA Health
01.2021 - 03.2021
Patient Care & Urgent Care Representative II
Providence St. Johns Medical Center
08.2019 - 11.2020
Case Management Coordinator
California Rehab Institute
11.2018 - 08.2019
Customer Service Representative
Conifer Health Solutions
08.2017 - 09.2018
Call Center Representative & Patient Referral Coordinator
UCLA Health
01.2015 - 01.2017
Front Office Secretary
Burbank Pediatrics
11.2013 - 12.2014
Front Office Assistant
Dr. Ian Taras Gynecology
06.2008 - 09.2013
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