Phyllis Montenegro
Summary
Experienced Patient Advocate adept at conflict resolution, time management and relationship building. Caring Patient Advocate with successful background working as positive intermediary between hospitals and patients undergoing treatment. Excellent communication and problem-solving abilities. Bringing 12 years of experience in field.
Overview
34
34
years of professional experience
Work History
Patient Advocate Lead
Novant Matthews Medical Center
03.2012 - Current
- Consult with patients to make sure their stay has been remarkable
- Discuss issue with provider, nurses, caseworkers
- Defuse situation
- Locate lost and found items
- Reimburse lost items
- Deal with deaths and family members coping
- Speak with families that are not pleased with the care.
Contracted Benefit Specialist
Aerotek
11.2011 - 01.2012
- Verified insurance benefits pertaining to Remicade
- Contacted several insurance companies
- Checked COB'S
- Called Prior Auth department to see if Authorization was on file
- Contacted Pharmacy to see if Remicade was covered under Part D benefits
- Entered information into the system once completed.
Customer Service
Onstar
02.2010 - 11.2011
- Handled high volume of calls for customers that needed directions to different locations
- Placed directions to many locations
- Handled issues with their bills
- Dispatched for assistance when there was a vehicle in an accident
- Called in vehicle to make sure driver or any person in the vehicle were okay.
Customer Service
Connextions
09.2010 - 12.2010
- Handled high volume of calls
- Handled incoming calls for customers that needed to renew their prescription plan
- Completed customer information on the computer
- Gave brief description of different insurance plans and what they had to offer
- Checked medicine for customers to make sure it was covered under the plan
- Checked the different tiers the medicine came under and what the copay would be at the pharmacy.
Customer Service
Onstar
02.2009 - 08.2010
- Handled high volume of calls for customers that needed directions to different locations
- Placed directions to may locations
- Handled issues with bills
- Dispatched for assistance when there was a vehicle in an accident
- Called in the vehicle to make sure the driver or any person in the vehicle were okay.
Patient Accounts
Mount Carmel Hospital
01.2004 - 02.2009
- Directed patients to the floors if coming in for a procedure
- Called doctor's office to obtain scripts for patients that came in for any tests
- Collected copay's that was due at the time of service from the patient
- Assisted patients in the emergency room and registered them at the bed side
- Answered multi-line telephone system
- Obtained information from the EMT'S that came in with trauma patients
- Verified insurance information
- Ran Medicare and Medicaid insurance to make sure they were still active
- Registered patients for Pre-Admission testing for any upcoming procedures
- Worked in cashiers office counting all the money from different departments
- Tallied up all the money and made deposits ready for pick up
- Registered patients for outpatient as well as inpatient surgical procedures.
- Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records.
Patient Financial Specialist
North Shore University Hospital
04.1998 - 08.2003
- Entered data in system while patients are in the hospital
- Managed multi-lined phones
- Process authorizations for inpatient admissions
- Handle reports that need to be sent to insurance companies
- Run Medicare and Medicaid accounts
- Spoke with patients in their rooms due to issues with insurance card
- Handled workers comp cases as well as No-fault accounts
- Called insurance companies to verify insurance was active and obtain the coverage information.
High dollar Team
Vytra Healthplans
03.1990 - 02.1997
- Processed claims for doctors as well as hospital
- Processed workers comp claims
- Spoke with clients that had issues with their accounts
- Made corrections on claims that came back denied from the insurance company
- Received high volume of calls
- Made outbound calls to insurance claims offices
- Coded accounts with ICD9 codes and CPT codes.
- Effectively resolved customer complaints or issues while maintaining a professional demeanor and upholding company standards.
Education
Associate of Arts - Business Management
University of Farmingdale College
Melville, NY06.1984
Skills
- Patient Rights
- Proactive Problem Solving
- Organized nature
- Resource Utilization
Awards
- Employee of the month
- Highest copay collected
- Dedicated worker
- Sunshine Award
Timeline
Patient Advocate Lead
Novant Matthews Medical Center
03.2012 - Current
Contracted Benefit Specialist
Aerotek
11.2011 - 01.2012
Customer Service
Connextions
09.2010 - 12.2010
Customer Service
Onstar
02.2010 - 11.2011
Customer Service
Onstar
02.2009 - 08.2010
Patient Accounts
Mount Carmel Hospital
01.2004 - 02.2009
Patient Financial Specialist
North Shore University Hospital
04.1998 - 08.2003
High dollar Team
Vytra Healthplans
03.1990 - 02.1997
Associate of Arts - Business Management
University of Farmingdale College
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