Ozella Grimes
Houston,TX
Summary
Patient Access Representative with more than 15 years of experience working in a busy medical office serving diverse populations. To acquire a challenging position applying my current aptitude, as well as broaden my knowledge through new career-minded opportunities. Personable and dedicated Customer Service Representative with extensive experience in medical industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.M
Overview
15
15
years of professional experience
1
1
Certification
Work History
Insurance Follow-up Specialist
Harris Health System
Houston, TX
02.2022 - Current
- Insurance verification, Claim appeals, Medicare follow up denials and appeals, Billing and collections, Update demographics, Check emails daily, answer calls from patients regarding billing and insurance benefits questions.
Patient Communication Representative
American Health Connection Call Center
Beverly Hills, CA
01.2021 - 02.2022
- Responsible for performing administrative tasks, such as managing and monitoring several electronic information databases, E Clinical, Citrix, and Epic
- Utilization of many programs to verify insurance coverage and eligibility, including employer-based group health plans
- Training and developing other staff members, also answering the phones, scheduling appointments, billing, and submitting insurance claims
- Maintaining patients charts and managing a multiple line telephone system
- Pre-registration and financial clearance of over 600 patients account on a monthly basis with an accuracy rate of over 99%
- Collaboration with management and clinical staff to improve patient outcomes and service using specific performance improvement models
- Schedule, check-in, and set up Covid 19 vaccines.
Patient Access Representative/Scheduler
Ochsner Hospital
Kenner, LA
08.2016 - 05.2020
- Admitting for surgery, Scheduling, Payment counselor, Multi physician clinic and Sports Medicine
- Greet patients and their caregivers and record pertinent information into a computer database, update demographics and insurance
- Records insurance information and obtain pre-approval for treatment if needed
- Relays information between patients and other staff members, and provides them with updates as needed
- Prioritizes the order of care so that the most critical patients are seen first
- Keep paper and electronic medical records, and update these records as needed
- Provides information to insurance companies in order to assist with billing
- Assists patients during checkout, and ensures they have post treatment instructions if required
- Calculates payment information, accepts funds, and credits accounts accordingly.
Verification Specialist/Quality Assurance Specialist
Health Management Systems
Irving, TX
08.2009 - 11.2011
- Cost Avoidance (CVA), Disallowance (PRE), Medical Support Enforcement (MSE) for State Medicaid
- Medicaid coverage ranges from month to month where I look for the spans of coverage in claims that were paid
- Monitored outbound calls to ensure quality and ethical practices
- Reviewed online work submitted by verifications analyst
- Created feedback spreadsheets for team leads and supervisors
- Trained over 100 new employees and motivated team members and fellow leads
- Expertise in over 30 verification websites dealing with all levels of commercial and government health plans such as HMO, PPO & Medicare Part C policies
- Create payment schedules to ensure monthly reimbursements are delivered to families who pay for health insurance
- Prepare excel spreadsheet to ensure health insurance premium payments are delivered to families who pay for commercial health insurance
- Handled confidential information to ensure privacy for all active and inactive Medicaid recipients
- Documented insurance carrier issues and submitted reports to supervisors.
Bus Driver
Red Oak ISD
Red Oak, TX
08.2009 - 11.2011
- Transport students to and from school, field trips on weekends, and sports games
- Endorsement passenger and school bus
Education
Associate - Medical Administrative Assistant
Healthcare Training Institute
02.2016
High school diploma or GED - GED
02.2010
Skills
- Data entry
- EMR systems
- EClinicalWorks
- English
- Bus Driving
- Epic
- Insurance Verification
- Medical Office Experience
- Medical Scheduling
- HIPAA
- Medical Terminology
- Medical Billing
- ICD-10
- Quality Assurance
- Computer Operation
- School Bus Driving
- Medical Records
- Athenahealth
- Customer service
- CPT Coding
- QuickBooks
- Transcription
- Triage
- ICD-9
- Medical Coding
- Windows
- Phone Etiquette
- Cerner
- ICD Coding
- Clerical Experience
- Medical Receptionist
- Microsoft Powerpoint
- Teaching
- Filing
- Intake
- Multi-line phone systems
- Debits & credits
- Leadership
- Cash handling
- Documentation review
- Experience Administering Injections
- Auditing
- LAN
- WAN
- Typing
- Commercial driving
- Effective Communication Abilities
- Strong Analytical Skills
- Conflict Resolution Abilities
- HIPAA Compliance
- Medical Billing Proficiency
- Policy Interpretation
- Customer Service
- Credit Card Payment Processing
- Medical Terminology Knowledge
- Customer Service Excellence
- Account Updates
- Remote Office Availability
- MS Office
- Attention to Detail
- Active Listening
- POS Systems and Ordering Platforms
- Professionalism
- Work Prioritization
Certification
- Medication Administration
- Certified Notary Public
- Driver's License
- CDL B
- Passenger Endorsement
- School Bus Endorsement
- CDL C
Work Authorization
Authorized to work in the US for any employer
Assessments
- Customer focus & orientation, Highly Proficient, 05/01/20, Responding to customer situations with sensitivity
- Medical receptionist skills, Proficient, 12/01/20, Managing physician schedules and maintaining accurate patient records
- Verbal communication, Proficient, 04/01/20, Speaking clearly, correctly, and concisely
- Work style: Reliability, Expert, 12/01/20, Tendency to be dependable and come to work
- Front desk agent (hotel), Highly Proficient, 06/01/20, Selecting hotel rooms based on verbal requests and identifying errors in hotel data
- Supervisory skills: Motivating & assessing employees, Highly Proficient, 08/01/20, Motivating others to achieve objectives and identifying improvements or corrective actions.
- Work motivation, Proficient, 07/01/21, Level of motivation and discipline applied toward work
- Verbal communication, Proficient, 06/01/21, Speaking clearly, correctly, and concisely
- Medical receptionist skills, Proficient, 11/01/21, Managing physician schedules and maintaining accurate patient records
Personal Information
Willing To Relocate: Anywhere
Timeline
Insurance Follow-up Specialist
Harris Health System
02.2022 - Current
Patient Communication Representative
American Health Connection Call Center
01.2021 - 02.2022
Patient Access Representative/Scheduler
Ochsner Hospital
08.2016 - 05.2020
Verification Specialist/Quality Assurance Specialist
Health Management Systems
08.2009 - 11.2011
Bus Driver
Red Oak ISD
08.2009 - 11.2011
Associate - Medical Administrative Assistant
Healthcare Training Institute
High school diploma or GED - GED
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