Ramona Dixon
Summerville,SC
Summary
Experienced customer service professional with a proven track record of delivering exceptional customer service and support to a diverse clientele. Skilled in addressing customer inquiries, resolving issues, and ensuring customer satisfaction through effective communication, problem-solving, and a customer-centric approach. Proficient in utilizing various customer service tools and technologies to streamline operations and improve overall service quality. Committed to maintaining a positive customer experience while contributing to the success of the organization.
Overview
15
15
years of professional experience
Work History
Infusion Intake Coordinator (Prior Authorization)
Articularis Healthcare
Summerville, SC
12.2022 - 05.2023
- Requested, received, and input incoming prior authorization requests into EMR system.
- Performed insurance benefit verifications and prior authorizations for each patient.
- Communicated financial policies to patients before procedures.
- Monitored daily infusion schedule and scheduled patients accordingly.
- Handled prior authorization denials and appeal process.
- Managed department outlook inbox,promptly addressing inquiries and conducting timely investigations.
- Ensured all necessary information for requests and clinical packets is included and accurate.
- Specialized in processing benefits and authorization requests for injectable drugs and IV infusion medications related to rheumatology issues under medical benefits (buy and bill).
- Verified patients' eligibility and enrolled them in Pharmaceutical Copay Assist programs.
- Entered referrals into appropriate system based on type of referral obtained.
- Communicated with referral sources, physicians, and associated staff to check documentation for proper signatures.
Emergency Room Patient Access Specialist
Roper St. Francis Berkeley Hospital
Summerville, SC
11.2021 - 12.2022
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Greeted patients and caregivers, recording pertinent information into computer database.
- Recorded insurance information and obtained pre-approval for treatment if needed.
- Relayed information between patients and other staff members, providing updates as needed.
- Maintained paper and electronic medical records, updating them as needed.
- Provided information to insurance companies to assist with billing.
- Assisted patients during checkout and ensured they had post-treatment instructions if required.
- Collected patients' financial liabilities and provided explanations of insurance benefits, financial assistance, and self-pay billing.
- Performed patients' preadmission, registration, room assignment, and other related tasks throughout their patient care.
Precertification Specialist/Radiology Scheduler
Northside Hospital Radiology
Atlanta, GA
01.2017 - 04.2021
- Verified insurance benefits and obtained authorization and precertification for radiology exams and testing.
- Pre-registered and scheduled moderately complex procedures and exams, coordinating multiple resources for patient services.
- Maintained tracking of patients' scheduled appointments, ensuring eligibility and authorization information was entered into the system.
- Served as a liaison between patients, referring physician's offices, and insurance companies, informing them of procedure authorization delays/denials.
- Scheduled high-activity exams for over 59 outpatient sites and 3 hospitals in a high call volume environment.
- Performed various administrative tasks by filing, copying and faxing documents.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
Radiology Scheduler II
Northside Hospital Radiology
Atlanta, GA
07.2013 - 01.2017
- Served as a liaison for staff, hospital personnel, medical staff, and physicians' offices.
- Handled 90+ calls per day, scheduling appointments and performing verification according to provider rules and guidelines, documenting service requests.
- Conferred with patients to obtain and confirm pertinent billing and demographic information and accurately entered patient and insurance information into the system.
- Scheduled all Biopsies, Mammograms, MRI, CT scans, and Ultrasound/Screening and Nuclear-Medicine procedures.
- Upheld HIPAA regulations and standards for protecting patient information.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
Customer Care Coordinator
One Call Medical
Alpharetta, GA
11.2008 - 07.2013
- Handled incoming and outgoing calls related to scheduling MRI's, CT's, and necessary medical testing for patients ordered by physicians or other medical professionals.
- Coordinated verification of 3rd party Worker's Compensation claims while serving as a liaison.
- Maintained confirmation files of Authorization by respective insurance companies.
- Followed strict HIPAA and company guidelines for handling sensitive personal and medical information.
- Communicated quickly and effectively, establishing claims, documentation, and case status.
- Entered customer demographic data into company databases.
Education
No Degree - Certified Professional Medical Coder
Coding Clarified LLC
Apache Junction, AZ05.2024
Associates Degree - Computer Systems Management
Westchester Business Institute
White Plains, NY05.1988
Skills
- Compassion
- Excellent Communication skills; Verbal and Written
- Interpersonal Skills
- Critical thinking
- Flexible & Adaptable
- Computer skills
- Team player
- Ability to multitask
- Customer service
- Good telephone etiquette
- Medical terminology
- Organization and Time management
- Problem solving ability
- Attention to Detail
- HIPAA
- Knowledge of radiological procedures
- Insurance verification/processor
Timeline
Infusion Intake Coordinator (Prior Authorization)
Articularis Healthcare
12.2022 - 05.2023
Emergency Room Patient Access Specialist
Roper St. Francis Berkeley Hospital
11.2021 - 12.2022
Precertification Specialist/Radiology Scheduler
Northside Hospital Radiology
01.2017 - 04.2021
Radiology Scheduler II
Northside Hospital Radiology
07.2013 - 01.2017
Customer Care Coordinator
One Call Medical
11.2008 - 07.2013
No Degree - Certified Professional Medical Coder
Coding Clarified LLC
Associates Degree - Computer Systems Management
Westchester Business Institute
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