Natalie Fleming

• Improved patient satisfaction by efficiently managing intake processes and providing exceptional customer service.
• Streamlined patient registration procedures for increased efficiency and reduced wait times.
• Enhanced accuracy of medical records with meticulous attention to detail during data entry tasks.
• Facilitated smooth communication between patients, healthcare providers, and insurance companies, ensuring timely processing of claims.
• Provided compassionate assistance to patients with special needs or language barriers by utilizing translation services when necessary.
• Implemented a user-friendly appointment scheduling system, resulting in higher patient satisfaction rates.
• Cultivated strong relationships with patients, fostering trust and loyalty through excellent customer service and genuine empathy.
• Collaborated with interdepartmental teams to streamline administrative processes for improved office workflow efficiency.
• Managed over 75 calls and emails per day while maintaining professionalism and effectively addressing inquiries related to appointments, billing, insurance coverage, and general questions about the facility''s services.
• Resolved complex insurance issues through diligent research and collaboration with insurers'' representatives to ensure accurate billing practices were followed consistently.
• Served as a valuable resource for both patients and colleagues alike regarding policy updates, procedure changes, and other pertinent information to maintain a high level of service consistency.
• Retrieved medical data for physicians and patients.
• Upheld HIPAA regulations and standards for protecting patient information.
• Catalogued patient data in clinical databases and registries according to regulatory practices.

• Managed incoming calls and directed to appropriate department
• Assisted nursing staff with patient care, ensuring timely completion of tasks and improved patient satisfaction.
• Contributed to positive patient experiences by greeting visitors, providing directions, and addressing inquiries professionally.
• Coordinated communication between medical staff and patients'' families, keeping everyone informed on treatment plans and progress updates.
• Reduced wait times for patients by accurately updating charts and promptly notifying physicians of changes in medical conditions or test results.
• Improved unit workflow by effectively prioritizing tasks and collaborating with team members to complete assignments in a timely manner.
• Ensured accuracy of medical documentation by meticulously transcribing physician orders and verifying information with nursing staff as needed.
• Maintained a clean, organized work environment for optimal efficiency in the delivery of patient care services.
• Supported hospital compliance efforts by adhering to privacy policies and HIPAA regulations when handling sensitive patient information.
• Expedited patient admissions process by gathering essential data from patients upon arrival and accurately entering it into electronic health records systems.
• Facilitated smooth discharge processes for patients, providing necessary documentation and instructions for follow-up care as directed by physicians or nurses.
• Managed inventory levels of office supplies, ensuring adequate stock was available at all times for efficient unit operations.
• Served as a liaison between the unit secretary team and other departments within the hospital, fostering strong working relationships that benefited overall facility function.
• Consistently met deadlines for completing administrative tasks while managing competing priorities during high-pressure situations on the unit floor.
• Upheld a high standard of patient service by addressing concerns and resolving issues in a timely, empathetic manner.
• Demonstrated flexibility in adjusting work hours to meet fluctuating demands of the unit, ensuring coverage during both peak times and staff shortages.
• Managed incoming calls and directed to appropriate department.
• Maintained patient confidentiality in line with HIPAA regulations.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Organized paperwork such as charts and reports for office and patient needs.
• Maintained rapport with physicians, nurse,s and other healthcare personnel.
• Processed lab paperwork and requests according to physicians' orders.
• Transcribed doctors' medication orders, lab test requests, and care plans.
• Monitored inventory levels and advised management of need for replenishment.
• Registered and verified patient records before triage with most up-to-date information.
• Coordinated referrals through insurance and other medical specialists and documented details in patient charts.

• Enhanced patient satisfaction by efficiently managing front desk operations and addressing inquiries in a timely manner.
• Streamlined appointment scheduling for improved patient flow and reduced wait times.
• Ensured accurate record-keeping by diligently updating patient information and verifying insurance coverage.
• Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
• Facilitated effective communication between patients, medical staff, and insurance companies to ensure seamless coordination of care.
• Provided compassionate customer service, creating a welcoming atmosphere for patients and their families.
• Assisted healthcare providers with administrative tasks, enabling them to focus on quality patient care.
• Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
• Reduced no-shows by implementing appointment reminder system through phone calls or text messages.
• Handled billing procedures accurately, ensuring prompt payment from both patients and insurance providers.
• Organized essential medical documents, streamlining access to vital information for healthcare providers during appointments.
• Increased efficiency in prescription refill requests by coordinating with pharmacies and obtaining necessary provider approvals promptly.
• Developed strong relationships with patients, fostering loyalty and trust in the practice''s services.
• Contributed to a positive work environment by collaborating effectively with colleagues and supporting team initiatives.
• Improved front office organization by implementing new filing systems and maintaining cleanliness in waiting areas.
• Coordinated specialist referrals for patients requiring additional care, facilitating efficient transfer of medical records as needed.
• Ensured optimal use of clinic resources by tracking inventory levels and submitting supply orders when needed.
• Coordinated patient scheduling, check-in, check-out and payments for billing.
• Organized paperwork such as charts and reports for office and patient needs.
• Maintained current and accurate medical records for patients.
• Transcribed phone messages and relayed to appropriate personnel.
• Checked patient insurance, demographic, and health history to keep information current.
• Invoiced patients accurately in line with charging guidelines.
• Printed prescription requests and queries in compliance with practice protocol.
• Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
• Assisted with medical coding and billing tasks.
• Processed medical insurance claims and payments.
• Scanning documents into EPIC via OnBase system
• Data Integrity and Insurance analysis for quality improvement

• Documentation specialist for Drug Compounding Manufacturer of High-End Sterile Drugs
• Streamlined documentation processes for increased efficiency in project completion and reduced errors.
• Enhanced company compliance with industry standards by conducting thorough reviews of all documentation and making necessary revisions.
• Supported cross-functional teams by providing accurate, timely, and well-organized documents for various projects.
• Conducted regular audits of existing documentation to identify gaps or outdated information, keeping all materials current and relevant.
• Managed multiple high-priority projects simultaneously, ensuring that all deadlines were met without compromising document quality.
• Collaborated with quality assurance team to comply with regulatory requirements.
• Produced on-time communications in support of new product submissions for regulatory agencies.
• Identified audit parameters to comply with quality standards.
• Reviewed document management protocols and user activities against internal records policies and document management standards.
• Gathered, reviewed and input Drug Batch Control reports each day using company software.
• Collaborated with subject matter experts to ensure accuracy and completeness of technical documentation, resulting in fewer revisions needed post publication.

• Setting up onsite Audit visits to provider offices
• Issuing member pull list with member information and measures being audited
• Retrieval and Data extraction (use of secured iron key to download records)
  Data and medical records extraction from EPIC/EMR, E-Clinical Works, Athena, and other systems.
• HEDIS measures analyzed according to NCQA Hybrid measures Examined chart documentation
  Chart review /Chart Abstractions and Corrections
• Enhanced client satisfaction by providing expert financial advice and personalized investment strategies.

• Onsite visits to provider offices Closing Gaps in Care
• Data Extraction from Medical Records
• HEDIS Hybrid Measures examined and abstracted
  Downloading of Medical Records
• Data Integrity and documentation correction

• NCQA Guidelines
Use of Facets data tracking system

• QSHR/Inovalon system.

• Performed Prior Authorizations for Cardiac and Radiology Services

• Processed authorizations for Non -Formulary Prescriptions

• Submitted E-Prescription request

• Submitted Prior authorization for all physicians within practice, Endocrinologist, Pulmonary, and Family Medicine
• Insurance eligibility and verification

• Revenue Cycle Medical Billing and Collections Representative
• Acted as an advocate for clients during creditor negotiations, working towards mutually beneficial agreements that facilitated debt resolution.
• Streamlined counseling processes by implementing efficient record-keeping systems and communication tools.
• Identified healthcare resources and programs for patients unable to meet financial obligations.
• Worked directly with clients to provide financial counseling and education using individualized counseling model and personal finance course.
• Analyzed financial needs of clients and developed tailored strategies to meet goals.
• Reduced errors in payment transactions by conducting thorough audits and identifying areas for improvement.
• Insurance eligibility and verification

• Medical Billing and Collections appeals representative

• Follow up rep for Commercial Managed Care claims, Medicare and Medicaid claims

• EOB processing

• Contractual allowance adjustments

•Claim payment review according to various contracts.

• Following up on implants that were billed for various DRG's

• Insurance eligibility and verification
• UB04 and HCFA corrections
• Data Integrity checking insurance and demographic information for quality control

• Held various temporary positions within health care industry performing Medical Billing and Collections duties
• Contract negotiations with various insurance payers
• Insurance Eligibility and verifications /Data Integrity
• Appeals /Grievance on rejected claims

• Held various positions within this healthcare facility during my time spent at this facility.
• Positions included Admitting Representative, Unit Secretary float pool, Pediatric ICU, Neonatal ICU, Operating
  Room, and Critical Care ICU.