SHERRIE SMITH-JAMES
Greensboro,NC
Summary
Initiative-taking and collaborative healthcare professional with 37+ years of experience in medical claims, billing, and direct patient customer support. This includes efficiently completing and coordinating administrative, operational, and registration tasks. Demonstrates a strong commitment to providing exceptional customer service, improving the patient experience, and supporting a learning mindset to adapt to organizational changes and modern technologies and systems.
Overview
18
18
years of professional experience
Work History
Patient Access Representative
Novant Health
01.2018 - Current
- Enhanced customer service capabilities, supporting patient care by efficiently managing high call volumes and addressing inquiries with professionalism
- Utilized advanced office software to access and update patient information, ensuring HIPAA-compliant data management
- Coordinate between patients and healthcare professionals to meet patient requirements
- Create invoices, process payments, and make deposits, as part of financial operations
- Communicate extensively with patients to aid, support and guidance
Insurance Verification Specialist
Novant Health
01.2011 - 01.2018
- Facilitated insurance verification, enhancing claim approval accuracy and customer satisfaction
- Examined claims, records, and procedures to obtain approval of coverage
- Verified that patients had adequate insurance coverage prior to any procedures or appointment scheduling
- Ensured that all patient and insurance data was updated regularly and thoroughly analyzed into the company's computer system
- Retained strong medical terminology, obtaining an effort to better understand procedures
- Followed specific security regulations and guidelines to safeguard sensitive data, including patient medical records and payment card information
- Provided clients with information on the amounts covered under benefits plans in simple to understand terms
- Crafted professional communications, including email messages, memos, and business letters, ensuring clarity and consistency in all documentation
Medical Claims Specialist
Blue Cross & Blue Shield of North Carolina
01.2007 - 01.2011
- Input data into the system, ensuring that the provider coding information and reported services were correct
- Followed company policies and procedures, as well as state and federal insurance regulations
- Remained updated on HIPAA regulations, benefits claim processing, medical terminology, and other procedures
- Oversaw prompt claim billing and payment accuracy, significantly reducing processing delays and improving reimbursement rates
- Based on the payment or denials of medical claims based on well-established criteria for claims processing
- Determined and implemented techniques to improve the retrieval process of medical records
- Provided courteous aid to all parties, including patients, staff members, and insurance company representatives
- Entered patient insurance, demographic, and health information into software and verified records
- Served 85-95 customers daily with 100% accuracy, surpassing the team average of seventy customers/day
Education
Associates of Nursing -
Forsyth Technical Community College
Winston-Salem, NCAssociate of Arts - Medical Radiology
University of the District of Columbia
Washington, D.C.Skills
- Effective Communication
- Effective Stress Management
- Informed Decision Making
- Document Organization
- Effective Time Management
- Responsive to Change
- Effective Patient Communication
- Strategic Problem Analysis
- Analytical Problem Solving
- Accurate Record Tracking
- Advanced Skills in Microsoft Office
- EPIC Software Proficiency
- SMS Communication
- IDX Software Proficiency
Professional Overview
Initiative-taking and collaborative healthcare professional with 37+ years of experience in medical claims, billing, and direct patient customer support. This includes efficiently completing and coordinating administrative, operational, and registration tasks. Demonstrates a strong commitment to providing exceptional customer service, improving the patient experience, and supporting a learning mindset to adapt to organizational changes and modern technologies and systems.
Timeline
Patient Access Representative
Novant Health
01.2018 - Current
Insurance Verification Specialist
Novant Health
01.2011 - 01.2018
Medical Claims Specialist
Blue Cross & Blue Shield of North Carolina
01.2007 - 01.2011
Associate of Arts - Medical Radiology
University of the District of Columbia
Associates of Nursing -
Forsyth Technical Community College
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