PEGGY WASHINGTON
APOPKA,FL
Summary
Patient-focused Consumer Access Representative equipped with administrative and customer service expertise. Helps keep healthcare services proceeding smoothly by coordinating communications, referrals and policy enforcement. Talented in finding balanced solutions and resolving conflicts.
Overview
12
12
years of professional experience
Work History
CONSUMER ACCESS SPECIALIST ADVENTHEALTH LAB
AdventHealth
ORLANDO, FL
08.2022 - Current
- Completed registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements
- Reviewed patient information and verified accuracy of demographic data in order to register patients.
- Entered all patient information into the registration system accurately and efficiently.
- Maintained confidentiality of protected health information according to HIPAA guidelines.
- Adhered to department policies and procedures as well as established safety protocols.
- Scanned documents into EMR system; updated and maintained files according to established protocol.
- Generated forms related to registration process such as release of information forms and financial responsibility forms.
- Gathered personal and insurance information from each patient.
- Checked insurance benefits, received payments and provided receipts.
- Contacted insurance carriers to verify coverage, copays and deductible information for patients.
- Scanned medical documents and insurance cards to include in patient charts.
CONSUMER ACCESS SPECIALIST LEAD
AdventHealth
WINTER PARK , FL
07.2021 - 08.2022
- Greeted patients and provided them with information about their visit.
- Managed front desk operations, such as answering phones, responding to emails, and processing payments.
- Entered patient data into electronic health record systems accurately and timely.
- Assisted patients with completing forms related to their medical visits.
- Ensured HIPAA compliance standards were met throughout all areas of the practice.
- Ordered office supplies as needed while adhering to budgetary constraints.
- Responded promptly to messages left on voicemail system or email inboxes.
- Collected information, verified insurance and collected co-payments for patients as part of check-in process.
- Collected co-pays and insurance data, applying full and proper payment to patient accounts.
- Completed and safeguarded medical records, securing patient information to maintain confidentiality.
- Performed bookkeeping duties, preparing and sending financial statements or bills.
- Monitored patient flow and ensured efficient use of resources.
PATIENT ACCESS SPECIALIST
AdventHealth
LAKE NONA, FL
07.2020 - 07.2021
- Greeted patients and visitors in person or on the telephone; answered inquiries, provided directions and instructions.
- Verified patient insurance coverage, collected copays and other payments, processed credit card transactions.
- Maintained accurate records of patient registration information in electronic health record system.
- Ensured all required forms were completed accurately prior to patient visit.
- Performed data entry tasks associated with registrations such as entering demographic data into system database.
- Responded promptly to customer inquiries regarding account balances, billing statements, payment history.
- Identified discrepancies between billed charges versus what was actually received from the payer and insurance company.
- Educated patients about financial policies and procedures at facility; explained benefits of various payment options available.
- Served as a liaison between patients and third party payers ensuring that all necessary documents are submitted in a timely manner.
- Provided assistance with answering questions related to billing processes or assisting customers with payment plans.
- Applied HIPAA privacy and security regulations while handling patient information.
Insurance Reimbursement Specialist
Florida Hospital
MAITLAND , FL
07.2012 - 12.2020
- Reviewed and processed insurance reimbursement claims for accuracy and completeness.
- Developed detailed knowledge of insurance policies, procedures, and regulations to ensure compliance.
- Analyzed medical records to ensure accurate coding in accordance with policy requirements.
- Maintained up-to-date records of all claims activity and payments received.
- Generated reports on claim status for management review.
- Processed appeals for denied or underpaid claims.
- Evaluated patient accounts for accuracy and appropriate payment levels according to policy guidelines.
- Prepared documents for submission to insurance companies, including invoices, authorizations, and itemized bills.
- Conducted research into potential sources of reimbursement from government programs or private insurers.
- Resolved customer inquiries regarding insurance coverage and reimbursement issues in a timely manner.
- Ensured that all paperwork was properly completed prior to submitting the claim forms.
- Monitored outstanding claims on a regular basis until resolution is achieved.
- Identified trends in denials or rejections of claims by payers and developed solutions accordingly.
- Collaborated with other departments within the company to improve processes related to insurance reimbursements.
- Adhered to HIPAA guidelines when handling sensitive patient information.
- Responded promptly to any requests from external auditors related to reimbursement activities.
- Researched rejections, investigating problems to appeal claims.
- Maintained confidentiality and integrity of patient data.
- Enforced adherence to Florida and federal reporting regulations by performing regular compliance audits.
Education
High School Diploma -
Apopka High School
Apopka, FL06.1989
Prosci Practitioner
Certified Medical Administration Assistant
Skills
- Collections
- Authorizations
- Customer Support
- Caring and Empathetic
- Calm and Effective Under Pressure
- Building Rapport and Credibility
- Resolving Problems
- Attention to Detail
- Patient Confidentiality and Data Security
Timeline
CONSUMER ACCESS SPECIALIST ADVENTHEALTH LAB
AdventHealth
08.2022 - Current
CONSUMER ACCESS SPECIALIST LEAD
AdventHealth
07.2021 - 08.2022
PATIENT ACCESS SPECIALIST
AdventHealth
07.2020 - 07.2021
Insurance Reimbursement Specialist
Florida Hospital
07.2012 - 12.2020
High School Diploma -
Apopka High School
Prosci Practitioner
Certified Medical Administration Assistant
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