Sheryl White
Enola,PA
Summary
Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Managed Care Coordinator
Intergal Resources Temp agency
Hopewell, NJ
06.2023 - 11.2023
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Evaluated clinical criteria against existing health plan guidelines to determine authorization status.
- Collaborated with other departments within the organization as needed to resolve issues or obtain additional information.
- Researched current payer policies related to specific services or diagnoses as needed.
- Explained eligibility details and affordability options to patients with kindness and respect.
Utlization Management Representative II
Beacon Health Options
Harrisburg, PA
02.2021 - 01.2023
- Researched and responded to inquiries from providers regarding coverage determinations.
- Prepared letters notifying providers of changes in coverage or denial decisions based on clinical criteria.
- Assisted with referrals
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or administrative staff.
- prepare authorization letters to be sent to providers.
- check in with providers for admissions and discharges.
- keep track of admissions and discharges on spreadsheet.
Patient Service Representative
UPMC Pinnacle
Harrisburg, PA
09.2018 - 09.2019
- Greeted patients upon arrival and directed them to the appropriate area.
- Provided customer service by answering patient questions and addressing concerns.
- Verified insurance information, collected payments, and scheduled appointments.
- Assisted with the completion of medical forms and records.
- Processed referrals from primary care physicians to specialists for further treatment or evaluation.
- Inputted patient demographic data into electronic health record system.
- Scanned documents into electronic health record system as needed.
Customer Service Representative
Med care DME Equipment /Upmc Pinnacle
Mechanicsburg, PA
03.2018 - 07.2018
- Provided product demonstrations to customers and healthcare professionals.
- Assisted patients in selecting the best equipment to meet their individual needs.
- Responded promptly to inquiries from existing or potential customers via phone, email or mail.
- Process all encounters from different facilities in Brightree system.
Patient Registrar Imaging
UPMC Pinnacle
Harrisburg, PA
07.2017 - 03.2018
- Greeted patients and answered questions regarding registration process.
- Collected patient demographic information, verified insurance coverage, and updated records as necessary.
- Processed payments for services rendered in a timely manner.
- Assisted with scheduling appointments, verifying benefits and authorizations for procedures.
- Entered patient data into electronic medical record system accurately and efficiently.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Verified insurance eligibility through online portals or by phone calls.
- Resolved discrepancies between billing systems and patient accounts quickly and accurately.
A/R Follow-up Specialist
UPMC Pinnacle
Harrisburg, PA
07.2014 - 07.2017
- Reviewed patient accounts and updated insurance information in the system.
- Identified and corrected errors related to billing, coding, and reimbursement from insurance companies.
- Researched and resolved insurance discrepancies for assigned accounts.
- Followed up with insurance carriers regarding claim status of unpaid or rejected claims.
- Utilized multiple payer websites to obtain detailed information about benefit eligibility and coverage levels.
- Generated reports detailing delinquent accounts receivable balances, aging analysis, denials and rejections.
- Initiated appeals when necessary for denied or underpaid claims as required by contract guidelines.
- Responded promptly to inquiries from internal staff members and external customers regarding account status updates.
- Monitored payments received from insurance companies on a daily basis.
Education
High School Diploma -
Harrisburg High School
Harrisburg, PAAssociate of Arts - Human Services
Columbia International University
Columbia, SCSkills
- Decision-Making
- Critical Thinking
- Epic Systems
- Utilization Management
- HIPAA Guidelines
Certification
- Certificate Community Health Worker
- March 2022- July 2022
Timeline
Managed Care Coordinator
Intergal Resources Temp agency
06.2023 - 11.2023
Utlization Management Representative II
Beacon Health Options
02.2021 - 01.2023
Patient Service Representative
UPMC Pinnacle
09.2018 - 09.2019
Customer Service Representative
Med care DME Equipment /Upmc Pinnacle
03.2018 - 07.2018
Patient Registrar Imaging
UPMC Pinnacle
07.2017 - 03.2018
A/R Follow-up Specialist
UPMC Pinnacle
07.2014 - 07.2017
High School Diploma -
Harrisburg High School
Associate of Arts - Human Services
Columbia International University
Similar Profiles
Janay HortonJanay Horton
Medical Assistant at Adecco Staffing Agency {Temp Agency}Medical Assistant at Adecco Staffing Agency {Temp Agency}
Heather PiccioneHeather Piccione
CNA at WSI Temp AgencyCNA at WSI Temp Agency
Damaris BellDamaris Bell
Commercial Property Manager at Noble Staffing Temp AgencyCommercial Property Manager at Noble Staffing Temp Agency