SICILY PIERCE
HOUSTON,TX
Summary
Experienced Insurance Counselor with over 10 years' experience in Patient Services Counseling. Great reputation for resolving problems, patient advocacy, and just making sure the patient needs are met. Adept in patient advocacy and fostering positive patient experiences while minimizing collection efforts, increasing provider reimbursement, and maintaining compliance.
Overview
11
11
years of professional experience
Work History
Transplant Financial Specialist
Houston Methodist Hosptial
08.2023 - Current
- Handles the complete financial case management of transplant recipient, donor and all transplant related services. This includes management of various account work queues to capture potential errors before billing; ensure that the correct transplant plan code and coverage are applied and that effective term dates are accurate; perform bundled billing as applicable
- Interview patients by telephone and in-person to collect demographic, financial, insurance, referral physician and medical data. Provide financial counseling as applicable
- Verify insurance coverage for Transplant services in order to expedite billing and collection
- Complete periodic review of benefits to ensure transplant coverage is active throughout the requisite period
- Answer questions regarding insurance, hospital charges and payments for both Hospital.
- Investigate charge disputes, and if found to be valid prepare documentation to initiate correction
- Document all aspects of verification, pre-authorization and telephone communications in a timely manner. This includes keeping track of admission and discharge dates to update effective term dates
- Performs other duties as requested by senior management
INSURANCE COUNSELOR
DAVITA
01.2014 - Current
- Acts as a liaison between patients, facility teammates, billing office and the corporate office to resolve patient insurance issues and/or concern
- Educating patients about dialysis, including what to expect and their options
- Addresses any identified anomalies or discrepancies, research, and answers questions as needed
- Prepares analyzes and review monthly reports to track work progress on caseload
- Prepares patient reports from billing systems as an audit check to ensure the correct insurance information
- Provide QA team members with monthly information regarding the details of patients
- Facilitating a smooth transition for patients returning to their dialysis centers after hospitalization
Education
ASSOCIATE OF ARTS -
EASTERN OKLAHOMA STATE
06.1996
DIPLOMA -
NATHAN HALE HIGH SCHOOL
05.1991
Skills
- De-escalation skills
- Verbal communication
- Written communication
- Interpersonal communication
- Negotiation skills
- Analytical ability
- Strategic planning
- Organizational skills
- Managerial skills
- Leadership skills
Timeline
Transplant Financial Specialist
Houston Methodist Hosptial
08.2023 - Current
INSURANCE COUNSELOR
DAVITA
01.2014 - Current
ASSOCIATE OF ARTS -
EASTERN OKLAHOMA STATE
DIPLOMA -
NATHAN HALE HIGH SCHOOL
Similar Profiles
Diahann JonesDiahann Jones
Desktop Support Analyst at Houston Methodist HosptialDesktop Support Analyst at Houston Methodist Hosptial
Paola SarriaPaola Sarria
Registered Nurse, ICU Float Pool at Houston Methodist HosptialRegistered Nurse, ICU Float Pool at Houston Methodist Hosptial
Diane CoxDiane Cox
Registered Nurse at Methodist Hosptial Hill CountryRegistered Nurse at Methodist Hosptial Hill Country
Mikala JaramilloMikala Jaramillo
Software Engineer - Execute Trading Platform (Web Development) at JP MorganSoftware Engineer - Execute Trading Platform (Web Development) at JP Morgan
Edonya TimmonsEdonya Timmons
Teacher at Bertha Alyce Early Childhood SchoolTeacher at Bertha Alyce Early Childhood School