RAMONA ADAMS
Simpsonville,SC
Summary
Proactive, detailed and dedicated administrative professional, with an extensive knowledge of EMR, Pre Certification, and Scheduling compliance. Key strengths in critical thinking, collaboration, and patient centered care. Highly skilled at reorganizing electronic medical systems and increasing productivity through developing a new workflow process and or improving existing processes. Ambitious learner that takes initiative in a fast-paced environment.
Overview
18
18
years of professional experience
Work History
Patient Access Specialist
University of Vermont Medical Center
08.2023 - Current
- Maintains patient confidentiality by adhering to HIPAA guidelines and hospital policies.
- Provides exceptional customer service, addressing patient concerns promptly and professionally.
- Collects and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Handles sensitive situations involving distressed patients with empathy maintaining professionalism throughout interactions.
- Collaborates with clinical staff to ensure seamless coordination of care for patients.
- Participated in ongoing training programs to stay current with industry trends and best practices in patient access services.
- Contributed to a positive work environment through effective teamwork and communication with colleagues.
- Manages approximately 80 plus calls a day
- Maintained patient confidentiality by adhering to HIPAA guidelines and hospital policies.
Change Order Representatives
AVEANNA HEALTHCARE
08.2022 - 08.2023
- Enters demographics and other pertinent information into the digital system and ensure completion of all change order paperwork
- Verifies insurance coverage, explain benefit information to patients and case managers, collect and process payments as applicable
- Identifies patients' needs, clarify information, research every issue, and provide solutions
- Responsible for authorization submissions and authorization follow up by obtaining met daily expectations
- Responsible to determine a CRX and a valid prescription with formula calculation knowledge
- Responsible for processing and complete 28 change orders a day
- Insurance and payor portal navigation knowledge
- Meets daily, monthly, and quarterly metrics and goals set by management
- Communicates effectively with other departments to present solutions to any patient concerns
- Ensures work being performed meets internal and external compliance requirements
- Maintains confidentiality of all information; adhere to all HIPAA guidelines/regulations
- Various clerical work including faxing, scanning, and copying.
SENIOR MEDICAL SECRETARY/ PATIENT CARE COORDINATOR- Cardiothoracic
WEIIL CORNELL/ NEW YORK PRESBYTERIAN
03.2018 - 08.2021
- Coordinated and conducted front to back appointments for new and existing patients, including appointment scheduling, confirmation, re-scheduling and cancellations
- Scheduled and coordinated ancillary appointments, including surgeries, laboratory diagnostic test, radiology and follow up consultations
- Reviewed an average of 75 prior authorization request a day, with a 95% approval rate and an average turnaround time of 24 hours
- Acted as a primary liaison between patients, doctors' office, and patients' insurance companies; conducted patients insurance eligibility, communicated and collected associated fees, and verified pre- certification and obtained upgrades if needed
- Ensured that patient demographic, insurance information, verifications, eligibility; is established and documented
- Responsible for ongoing analysis and review of patient accounts; identifying delinquent accounts to trigger collection activities, and liaising with respective physicians to determine the next steps
- Maintained inventory of supplies, equipment and/ or reagents
- Maintained physician administrative (research and academic) and clinical/surgical schedules
- Prepared charges and payments for submission to the billing office
- Scanned documentations into EMR system as necessary
- Input and/or obtains authorizations/pre-certification's into and from within online systems
- Attended workshop, seminars and/or conferences as needed and based on functional needs
- Disseminated information to colleagues or staff as appropriate
- Trained new as well as veteran employees
- Ensured clinic and on-call responsibilities are covered during physicians' absences, followed clinic protocol for all cancellations.
SURGICAL COORDINATOR/SENIOR MEDICAL SECRETARY - Cardiology, Obstetrics & Gynecology, Urology/ Internal Med
WEILL CORNELL AFFILIATES
07.2016 - 03.2018
- Scheduled surgical cases to assigned medical staff, based on priority and medical emergency basis
- Coordinated surgical interventions and arrange for all necessary equipment and instruments to be present at time of surgery
- Provided pre-operative and post-operative instruction to patients
- Monitored incoming patient information from various sources and ensure that all information is properly scanned and entered into patients' file
- Ascertained that all presurgical forms and medical clearance documents are present, complete and accurate
- Sought approvals surrounding physicians' schedules and follow up on post-operative visits
- Worked with patients' insurance companies to obtain necessary documents and authorizations for payments for surgical procedures
- Greeted and checked patients in, while assuring all medical information is up to date
- Verified insurance information, collected payments from patients, ad reconciled daily cash reports
- Scheduled any outside appointments, generated referrals, in addition to telephone coverage
- Liaised with other doctors' offices, imaging offices, and all other organizations as needed
- Addressed common medical and insurance question via phone and e-mail
- Provided training to assist new patient care coordinators.
- Handled sensitive information discreetly, maintaining confidentiality when managing personnel files or financial data.
- Answered multi-line phone system and enthusiastically greeted callers.
- Scheduled appointments and conducted follow-up calls to clients.
ADMINSTRATIVE ASSISTANT
ADIRONDACK ORAL & MAXIOFACIAL SURGERY
06.2014 - 06.2016
- Managed approximately 40 calls, emails and faxes per day
- Conducted patient check ins and check outs
- Oversaw express bill weekly and daily deposit reports
- Conducted verification, patient care, greeter, collections
- Assisted in accounts receivable, and appointment scheduling
- Regulated the financial disclosures, appointment scheduling (multi phone/fax operator)
- Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
- Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
- Promoted a positive work environment through effective communication skills and fostering professional relationships among colleagues.
MEDICAL ASSISTANT/ RECEPTIONIST - Internal Medicine
NEW YORK-PRESBYTERIAN/LOWER MANHATTAN
10.2006 - 07.2008
- Responsible for appointment scheduling, filing, faxing, insurance verification, test referral
- Performed injections, phlebotomy - finger sticks, venipuncture, laboratory follow up, urinalysis
- Performed and prepped vital signs on multiple patients, performed ekg's, throat cultures, spirometry test, centrifuging, ear irrigations.
Education
Medical Assistant -
ALLEN SCHOOL
Brooklyn, NY06.2005
Business - H.S Diploma -
MARTIN LUTHER KING HIGHSCHOOL
New York, NY06.2003
Skills
- KNOWLEDGE CPT, ICD 9 & ICD 10 coding
- Working knowledge of third- party payor reimbursement - Medicare, Medicaid, Managed Care and commercial insurances
- HIPAA Compliance
- Insurance Billing
- Patient Scheduling
- Insurance Verification
- Patient Registration
- Multi-Line Telephone Systems
- Scheduling Diagnostic Procedures
- Patient Education
- Insurance Authorizations
- Claims Handling and Coverage Verification
- Medical insurance
- Insurance Forms Processing
- Benefits Explanation
References
REFERENCES FURNISHED UPON REQUEST
Timeline
Patient Access Specialist
University of Vermont Medical Center
08.2023 - Current
Change Order Representatives
AVEANNA HEALTHCARE
08.2022 - 08.2023
SENIOR MEDICAL SECRETARY/ PATIENT CARE COORDINATOR- Cardiothoracic
WEIIL CORNELL/ NEW YORK PRESBYTERIAN
03.2018 - 08.2021
SURGICAL COORDINATOR/SENIOR MEDICAL SECRETARY - Cardiology, Obstetrics & Gynecology, Urology/ Internal Med
WEILL CORNELL AFFILIATES
07.2016 - 03.2018
ADMINSTRATIVE ASSISTANT
ADIRONDACK ORAL & MAXIOFACIAL SURGERY
06.2014 - 06.2016
MEDICAL ASSISTANT/ RECEPTIONIST - Internal Medicine
NEW YORK-PRESBYTERIAN/LOWER MANHATTAN
10.2006 - 07.2008
Medical Assistant -
ALLEN SCHOOL
Business - H.S Diploma -
MARTIN LUTHER KING HIGHSCHOOL
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