REASA SIMMONS
Raytown,MO
Summary
Committed and reliable healthcare professional offering 25 years of experience in the healthcare industry. My years of experience have prepared me to be able to focus on key details such as first aid and patient safety, diagnostic testing, medical terminology as well as electronic medical records that allows me to perform high quality patient safety, comfort, and dignity to any individual that is in my care. My experience also gives detailed knowledge in the use of MS Excel, Microsoft Word, 10 key by touch along with extensive customer service.
Overview
10
10
years of professional experience
Work History
Client Account /Counselor Technician
ReDiscover Mental Health Transitions Clinic
03.2020 - Current
- Front Desk Assistant duties included welcoming guests, checking them in, distributing room keys, taking payment from customers, responding to guests' issues and complaints, validating registrations and/or enrollments, evaluating billing data elements, resolving billing errors, completing secondary claim processes, maintaining records and case files, posting third party payments, identifying outstanding client balances, processing refunds, submitting client spend down charges, maintaining spend down information, performing medical records data entry/documentation, collaborating with community agencies, and developing rehabilitation plans.
- Contributed to a positive therapeutic environment by maintaining confidentiality and respecting client boundaries.
- Coordinated with external agencies to facilitate seamless referral processes for additional support services as needed.
- Facilitated group therapy sessions focused on topics such as anger management, stress reduction, and effective communication skills.
- Enhanced client progress by conducting thorough assessments and developing comprehensive treatment plans.
- Participated in ongoing professional development training to stay current with best practices in counseling techniques and theory.
- Collaborated with multidisciplinary teams to create individualized care strategies for each client.
- Maintained accurate records of session notes, treatment plans, and client correspondence, ensuring compliance with legal requirements.
- Sharing expertise on best practices for successful outcomes.
- Developed strong rapport with clients, fostering trust that enabled open communication during sessions.
- Implemented behavior modification techniques within group settings, leading to improved interpersonal relationships among participants.
- Provided crisis intervention services, deescalating tense situations and connecting clients to appropriate resources.
- Educated client on available community resources, empowering them to make informed decisions about their care.
- Evaluated program effectiveness by tracking client progress and adjusting treatment plans as needed.
- Created a supportive environment by promoting inclusivity and cultural sensitivity during all interactions with clients and colleagues.
Healthcare Claim Specialist
DST Systems
03.2017 - 03.2020
- Responsible for processing patient claims for hospitals and clinics, resolving claim errors, documenting billing activity, system balancing, analyzing information, responding to client requests, and documenting/recording information.
- CATS (Processing System), Sparcs (Processing Systems), HBS (RX Claim Processing
System), MS Outlook, Word and Excel, Skype Business, People Safe, Emdeon, WELLMARK,
Business CAS, Microsoft Office Communicator, MHC- Professional claim types, AWD- work
distributor, Clarity, I community, Workday Systems
Inbound and outbound phone calls, resolving customer complaints and inquiries
Resolving claim errors on billing system in timely manner by reviewing claim
error reports and taking appropriate action.
Responsible for documenting billing activity including but not limited to following bill
dates, notes, and electronic note posting.
Responsible for system balancing ensuring all downloaded/translated claims are
submitted along with completing daily billing balancing form.
Analyzed information to determine correct party is being billed.
Responded to client requests for information via email and telephone. Documenting/Recording
Information — Entering, transcribing, recording, storing, or maintaining information in written or
electronic/magnetic form.
Customer Quality Specialist
Apria Healthcare
03.2014 - 03.2017
- Duties included verifying insurance information, obtaining clinical information, ensuring proper selection of information, responding to telephone, fax, and orders, resolving patient/customer complaints, investigating data entry issues, making inbound/outbound calls, making decisions and solving problems, and getting information.
- Obtain clinical information needed for order processing or
reimbursement.
Ensure proper selection of information online to ensure timely delivery and appropriate
revenue recognition for order
Respond to telephone, fax, and orders from referral sources and patients.
Resolve patient/customer complaints by identifying problems and coordinating
appropriate corrective action.
Investigate data entry issues to ensure accurate reporting and billing for claim process
Inbound /outbound calls in office setting.
Making Decisions and Solving Problems — Analyzing information and evaluating results to
choose best solution and solve problems.
Getting Information — Observing, receiving, and otherwise obtaining information from all
relevant sources. - Played a vital role in ensuring compliance with industry regulations, minimizing potential risks associated with non-conformance events.
- Boosted customer confidence by conducting regular audits on suppliers and ensuring adherence to quality standards.
- Facilitated root cause analysis for recurring product issues, implementing corrective actions that significantly reduced future occurrences.
Education
H.S. Diploma -
Seton High School
Bachelor of Health Science - Healthcare
UMA
Clearwater, FLAssociate Degree - Health Management
Penn Valley
Kansas City, MO05.2018
Skills
- First Aid and Patient Safety
- Diagnostic Testing
- Medical Terminology
- Electronic Medical Records
- ICD-9 and 10
- MS Excel
- Venipuncture/Capillary Blood Collection
- Assist clients in handling details of daily life
- Evaluate potential problems in home or work environments of clients
- Medical Billing
- Claims Specialist
- Medical Records
- Medical Coding
- MS Word
- 10 Keys
- Specimen Preparation
- Develop and maintain relationships with community referral sources, such as schools or community groups
- Customer Service
- Privacy/HIPPA Regulations
- Patient Advocacy
- Patient Support
- Medical Insurance
- Medical Administrative Assistant
- Face-to-Face Discussions
- Data-driven decision-making
- Substance Abuse Knowledge
- Professional boundaries
- Relapse Prevention
- Community Resources
- Client Advocacy
- Self-care strategies
- Mental Health Assessment
- Individual Counseling
- Clinical Documentation
- Medication Administration
- Team Collaboration
- Mental Health Support
- Documentation And Reporting
Personal Qualifications
Committed and reliable healthcare professional offering 25 years of experience in the healthcare industry. My years of experience have prepared me to be able to focus on key details such as first aid and patient safety, diagnostic testing, medical terminology as well as electronic medical records that allows me to perform high quality patient safety, comfort, and dignity to any individual that is in my care. My experience also gives detailed knowledge in the use of MS Excel, Microsoft Word, 10 key by touch along with extensive customer service.
Timeline
Client Account /Counselor Technician
ReDiscover Mental Health Transitions Clinic
03.2020 - Current
Healthcare Claim Specialist
DST Systems
03.2017 - 03.2020
Customer Quality Specialist
Apria Healthcare
03.2014 - 03.2017
H.S. Diploma -
Seton High School
Bachelor of Health Science - Healthcare
UMA
Associate Degree - Health Management
Penn Valley