Natalie M. Heard
Medical Coordinator
Brooklyn,NY
Summary
Healthcare professional with solid track record in provider relations and advocacy, known for maintaining high standards and delivering results. Expertise in building strong provider networks and resolving complex issues effectively. Highly collaborative team player who adapts to changing needs and consistently drives positive outcomes through excellent communication and analytical skills.
Overview
21
21
years of professional experience
2
2
years of post-secondary education
2
2
Certifications
Work History
Provider Relations Advocate
Fidelis Care New York
10.2022 - Current
- Communicated with Managed Care Organizations
- Viewed and assisted with authorizations
- Verification of insurance and benefits for HMO, Medicaid and Commercial payers
- Ability to communicate professionally and efficiently on the phone
- Ability to demonstrate understanding of technical medical terminology (e.g
- Copayments, deductible, coinsurance, primary/secondary payor, referral)
- Enhanced member satisfaction levels by swiftly addressing escalated grievances related to billing or out-of-network services.
- Developed strong working relationships both internally across departments as well as externally among contracted providers to ensure seamless coordination of services.
Administrative Assistant
Employee Health at Maimonides
01.2022 - 03.2022
- Scheduled employees for appointments via calendar and phone
- Called up employees to monitor their symptoms for Covid to clear them to return to work
- Filed charts and medical records
- Checked to make sure they received their vaccination
- Systems EPIC, Eagle gold, SCI, Chartmax, Nextgen
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Protected confidential data through rigorous adherence to privacy policies and secure documentation systems.
- Provided timely responses to client inquiries, effectively addressing concerns and fostering relationships.
- Assisted with human resources tasks such as updating employee files or submitting time-off requests per company policy guidelines.
Administrative Coordinator (Part-Time)
Wellthy
07.2021 - 12.2021
- Manual outreach to nannies and HHA agencies
- Conducted research & data entry
- Sourcing
- Interviewed candidates and called the candidate's references
- Engaged with department leaders to ensure strategic alignment with organizational objectives.
- Provided exceptional administrative support to executive staff members through meticulous organization skills and attention to detail.
- Answered phone calls and responded to inquiries from customers, vendors and other external contacts.
Patient Care Assistant (Part-Time)
LifeCare Advantage, LLC
04.2020 - 09.2020
- Enhanced patient evaluation by gathering crucial medical information like height, weight, and vital signs.
- Assisted in meal preparation and feeding support for patients with various dietary restrictions or swallowing difficulties
- Aided in the prevention of bedsores through regularly repositioning of patients according to care plans.
- Monitored vital signs regularly, assisting in early identification of potential health issues.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Recognized and reported abnormalities or changes in patients' health status to case manager.
- Provided emotional support to patients during difficult moments, fostering trust and rapport.
- Participated in ongoing training opportunities to stay current on best practices within the field of patient care.
- Recorded temperature, blood pressure, pulse, or respiration rate as directed by medical or nursing staff.
Patient Care Assistant (Part-Time)
Best Choice
03.2018 - 04.2020
- Gathered medical information, weight and height measurements and vital signs.
- Proactively reduced the risk of bedsores through consistent patient repositioning aligned with established care plans.
- Engaged in continuous training to enhance knowledge of patient care best practices.
- Enhanced patient care by assisting with meal preparation and addressing individual dietary needs.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Oversaw the maintenance of sanitation, cleanliness, and organization in designated service zones.
- Prioritized confidentiality by diligently adhering to HIPAA regulations when handling sensitive patient information.
- Promoted a positive patient experience by actively listening and empathizing with their needs and emotions.
Data Entry Clerk
Brooklyn Chiropractic Office
06.2015 - 02.2017
- Achieved exceptional accuracy and efficiency in completing all data entry tasks.
- Systematically analyzed and verified input data in comparison to original documentation.
- Systematically organized files while ensuring documents were sorted and maintained efficiently.
- Validated the accuracy of entered data to deliver flawless reporting outcomes.
- Utilized Microsoft Office Suite to ensure precise entry of data into various computer systems.
- Facilitated efficient record-keeping by scanning documents and securely storing them in the database.
- Verified entered data against source documents to maintain consistency across multiple platforms within the organization.
- Assisted in development of new data entry protocol, leading to improved data integrity.
Appeals Specialist
Amerigroup Health plus
12.2012 - 09.2014
- Provided coordination, management, and resolution of denied claims, appeals, and grievances and for the processing and coordination of all levels of member and provider medical appeals, payment appeals, and dispute activities
- Ensure compliance with all department timelines including telephone service standards and turn-around times
- Manage pending claims, authorization, or error reports as assigned
- Complete initial screening and make outreach calls to providers
- Collaboratively work with other departments to meet provider needs and support departmental business initiatives
- Maintain and support doc, logs, and data entry to monitor activity and/or outcomes related to appeal coordination
- Complete Department letters or other correspondence, as assigned using the appropriate systems resources
- Increased customer satisfaction ratings through timely follow-up on appeal status inquiries, providing accurate information and addressing concerns promptly.
- Provided critical support in appeals matters, enhancing departmental effectiveness and decision-making.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
Healthcare Claims Analyst
Emblem Health
10.2011 - 09.2012
- Serves customers by adjudicating claims; completing audits; adjusting claim examiners' settlement limits
- Ensure compliance with all department timelines including telephone service standards and turn-around times
- Determining Medicare's liability to pay medical claims as to the secondary payer through researching data, analyzing, and interpreting Medicare secondary payer regulations
- Communicating with third parties such as attorneys, employers, or other insurance companies to receive additional claim info and ensure all compliance with time and quality regulations
- Strong analytical skills, ability to review documents and make suitable decisions
Health Assessment Coordinator
Elder Plan Health Inc.
01.2010 - 02.2011
- Coordinate administrative functions to ensure successful community outreach events
- Responsible for the preparation and planning of health screenings
- Worked in a system Amisys
Intake Coordinator
Elder Plan Health Inc.
10.2006 - 01.2010
- Admit new patients or residents into facilities after verifying insurance and completing admissions paperwork
- Medical facilities such as hospices, hospitals, and rehabilitation centers, worked in a system called Amisys
Medical Management Assistant
Elder Plan Health Inc.
02.2004 - 01.2005
- Achieved heightened client satisfaction through prompt inquiry handling and efficient problem-solving.
- Contributed to a positive work environment with excellent interpersonal skills and an ability to resolve conflicts effectively when necessary.
- Coordinated meetings and events, ensuring seamless communication between departments and stakeholders.
- Provided administrative support during key projects, ensuring timely completion and adherence to defined budgets or resource constraints.
- Improved office efficiency by streamlining filing systems, making document retrieval faster and more intuitive.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
Education
GED -
Suny Queens EOC
Queens, NY02-2021
Associate of Science - Medical Assistant
Touro College
New York, NY 05.2021 - 05.2023
Skills
MS Word
Advanced MS Excel
Outlook
ICD 10 Coding
Data Entry
Typing Skills - 45wpm
EMR
Faxing
Filing
Scanning
Scheduling
Insurance regulations
Policy interpretation
Healthcare industry
Call center experience
Data entry proficiency
Claims processing
Provider relations
Insurance verification
Salesforce CRM
HIPAA compliance
Strong interpersonal skills
Teamwork
Problem-solving
Time management
Excellent communication
Decision-making
Self motivation
Time management abilities
Analytical skills
Certification
HIPAA Standards
Timeline
Provider Relations Advocate
Fidelis Care New York
10.2022 - Current
Administrative Assistant
Employee Health at Maimonides
01.2022 - 03.2022
Administrative Coordinator (Part-Time)
Wellthy
07.2021 - 12.2021
Associate of Science - Medical Assistant
Touro College
05.2021 - 05.2023
Patient Care Assistant (Part-Time)
LifeCare Advantage, LLC
04.2020 - 09.2020
Patient Care Assistant (Part-Time)
Best Choice
03.2018 - 04.2020
Data Entry Clerk
Brooklyn Chiropractic Office
06.2015 - 02.2017
Appeals Specialist
Amerigroup Health plus
12.2012 - 09.2014
Healthcare Claims Analyst
Emblem Health
10.2011 - 09.2012
Health Assessment Coordinator
Elder Plan Health Inc.
01.2010 - 02.2011
Intake Coordinator
Elder Plan Health Inc.
10.2006 - 01.2010
Medical Management Assistant
Elder Plan Health Inc.
02.2004 - 01.2005
GED -
Suny Queens EOC