Shanissia Derby
Charlotte,NC
Summary
Dependable Interviewer with demonstrated abilities to handle issues with tact as well as remain calm under pressure. Offering 19 years of expertise in various roles for organizations in the Administrative Assistant/ Medical Field. An enthusiastic personality possessing outstanding skills in both Intrapersonal and Interpersonal Communication.
Overview
20
20
years of professional experience
Work History
Prior Authorization Specialist
Charlotte Gastroenterology & Hepatology
Charlotte
07.2023 - Current
- Responsible for obtaining prior approval for 15 providers in two locations, for Radiology procedures, EKG’s and Colonoscopies
- Initiating and coordinating peer to peer review and or provider courtesy review for cases resulting in denials
- Maintaining the status of referrals while in review and using various payor websites to check approvals
- Communicating with providers and nurses to clarify orders, diagnosis codes and procedure codes
- Answer incoming calls and patients' questions regarding procedures.
Patient Care Coordinator
Avance Care (Midtown)
03.2022 - 07.2023
- Front end office position in Primary Care office
- Duties include meet, greet and assisting patients promptly and efficiently
- Schedule new patients and update current patient's information in the EMR system
- Schedule and reschedule appointments, as well as coordinate walk-in patients
- Answer phones promptly and relay messages when necessary
- Collect co-pays, deductibles and coinsurances
- Explain fees, services and policies to patients
- Assist with patients accessing their patient portal
- Educate patients on their insurance plans and payments
- Verify benefits and eligibility with various insurance companies, via phone, chat and payor websites
- Verify if prior authorization is needed for Ultrasound services
- Obtain registration information and create charts in EMS accordingly
- Maintain the front desk and reception area in an organized, orderly fashion.
Patient Care Coordinator
Carolina Center for Oral & Facial Surgery
11.2021 - 01.2022
- Front end position in a fast-paced surgery office
- Duties included greeting patients in a polite and professional manner
- Answering phone, retrieving voicemails, investigating, and returning patient calls
- Forwarding calls to the appropriate parties
- Registering patients, scheduling new patient appointments in-person and over the phone
- Rescheduling appointments
- Contacting referring offices for missing documents
- Monitoring and responding to incoming emails
- Chart prep and purge
- Verifying and updating patient’s demographic information
- Scanning various documents into patient EMR.
Global Service Center Coordinator
Global Convergence Incorporated
Oldsmar, FL
03.2021 - 09.2021
- Responsible for sourcing IT technicians all over the country for various JP Morgan and Chase locations
- Analyzing, Updating, and creating spreadsheets utilizing Excel
- Answering inbound calls and troubleshooting technician issues
- Escalating to bank executives when necessary
- Assisting with access to Main Equipment Rooms and Technology Rooms
- Creating work order tickets for various systems
- Documenting Scope of Work and work completed to close out tickets.
ACCESS OUTREACH SPECIALIST
Atrium Health
Kannapolis, NC
12.2018 - 12.2020
- Assisted 300 + callers per week in a fast-paced environment
- Provided clerical support services in all areas of expertise and knowledge
- Routing of incoming phone calls to ensure patients messages are taken appropriately
- Taking incoming requests for medication refills, labs, and test results, if required
- Assists with patient message call backs and prescription refill requests
- Scheduled various types of appointments for physicians and clinical practitioners
- Relayed test results to patients when deemed appropriate
- Educated and assisted patients with evolving Covid instructions, information, and testing procedures.
HOSPITAL PATIENT SERVICE CLERK
Upstate Medical University
Syracuse, NY
07.2004 - 08.2018
- Verified demographics and insurance information to register patients in Epic
- Obtained necessary signatures for privacy laws and consent for treatment
- Applied HIPAA Privacy and Security Regulations while handling patient information
- Processed patient responsibility estimate determined by insurance at pre-registration
- Documented and managed patient information
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies, and list of accepted insurance plans
- Organized and maintained records by updating and obtaining both personal and financial information from patients
- Utilized customer service skills and detailed system knowledge to support hospital and clinic operations
- Educated patients and families on treatments, procedures, medications, continuation of care and community resources
- Accessed patient information through a variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
- Handled coordination between patients and healthcare professionals to meet patient needs in a timely manner.
Education
Some College (No Degree) - Communication Studies
Oswego State University
Oswego, NYSkills
- Data Entry
- Confidential data protection
- Web-based scheduling
- Problem Resolution
- Friendly, positive attitude
- Critical Thinker
- Award-Winning Customer Service
- Payment Processing
Personal Information
Title: Administrative Assistant
References
Available Upon Request
Timeline
Prior Authorization Specialist
Charlotte Gastroenterology & Hepatology
07.2023 - Current
Patient Care Coordinator
Avance Care (Midtown)
03.2022 - 07.2023
Patient Care Coordinator
Carolina Center for Oral & Facial Surgery
11.2021 - 01.2022
Global Service Center Coordinator
Global Convergence Incorporated
03.2021 - 09.2021
ACCESS OUTREACH SPECIALIST
Atrium Health
12.2018 - 12.2020
HOSPITAL PATIENT SERVICE CLERK
Upstate Medical University
07.2004 - 08.2018
Some College (No Degree) - Communication Studies
Oswego State University
Similar Profiles
Arianna RoussisArianna Roussis
Laboratory Administrative Assistant at Charlotte Gastroenterology & HepatologyLaboratory Administrative Assistant at Charlotte Gastroenterology & Hepatology
Kash SmithKash Smith
Healthcare Manager at Charlotte Gastroenterology & HepatologyHealthcare Manager at Charlotte Gastroenterology & Hepatology
Kathy DaltonKathy Dalton
RN Team Leader at Charlotte Gastroenterology & HepatologyRN Team Leader at Charlotte Gastroenterology & Hepatology