Skyy Santos
Summary
Forward thinking professional; Passionate about learning new skills and systems while contributing prior knowledge, experience, and education to an environment that will allow for both personal and professional growth.
Overview
7
7
years of professional experience
Work History
Leave of Absence Coordinator
Sedgwick Claims Management Services Inc.
Remote
11.2022 - Current
- Prepared or maintained employment records using human resources management system software.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Communicated with other departments to establish action plans and manage open claims to closure.
- Resolved claims by approving or denying documentation, calculating benefits due and determining compensation settlement.
- Investigated and analyzed requirements to improve timeliness of reports to customers.
Consumer Access Specialist (Temporary)
AdventHealth
Remote
09.2022 - 09.2022
- Documented patient counters in hospital system and initiated follow-up actions.
- Completed registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements.
- Verified patients' insurance and payment methods during admissions or check-in processes.
- Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Updated patient and insurance data and input changes into company computer system.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Created patient estimates using Epic.
Lab Registration Specialist (Temporary)
AdventHealth
Remote
07.2022 - 09.2022
- Registered patients for outpatient procedures and emergency services.
- Carefully checked insurance information for benefits coverage and input pre-authorization documents into system.
- Contacted insurance carriers to verify coverage, copays and deductible information for patients.
- Registered patients for diagnostic appointments, surgeries and medical consultations using electronic health record system.
- Accessed patient charts to collect, abstract and extrapolate patient data.
- Created patient estimates using Epic.
Patient Registration Coordinator
Option Care
Remote
12.2019 - 06.2021
- Screened patients before and during admissions processes.
- Registered patients using proper data entry procedures and fully compliant ICD-10 and CPT codes.
- Prepared patients for departure by coordinating discharge plans and paperwork.
- Interpreted physician orders to coordinate appropriate tests and verify compliance with admission criteria.
- Verified insurance and collected critical data elements to properly identify and bill patients.
- Liaised effectively with patients, doctors and staff members, assessing medical charts and promoting high level of communication and interaction.
- Communicated with patients to ensure quality of care and develop care plans.
Center Support Specialst
Select Physical Therapy
West Palm Beach, FL
02.2019 - 12.2019
- Assist the Revenue Cycle Manager with training, and supporting all front desk staff.
- Assist Revenue Cycle Manager with quality assurance audits to ensure accuracy of center services.
- Maintain system of controls to ensure proper cash handling.
- Work with patients, doctors, payors, and CBO to solve problems.
- Travel between eight clinics in Palm Beach county as needed to support staff.
- Managed customer expectations by clarifying needs, identifying options and recommending products and services.
Patient Service Specialist
Select Physical Therapy
Wellington, FL
03.2018 - 02.2019
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
- Compile and record medical charts, reports, and correspondence.
- Interview patients to complete insurance and privacy forms.
- Receive and process co-pay payments and post amounts to patient accounts.
- Schedule and confirm patient appointments, check-ups, and physician referrals.
- Answer telephones and direct calls to appropriate staff.
- Utilized technology and specialized software to maximize productivity.
- Obtained proper authorization and identification to release confidential medical records.
- Verify insurance and requested prior-authorization from insurance companies if necessary.
Education
High School Diploma -
Santaluces Community High School
Lantana, FL06.2014
Skills
- Multitasking and Organization
- Medical Data Collection
- Customer Service
- Quality Assurance
- Training
- Microsoft Word
- Microsoft Excel
- Attention to Detail
- EMR Software
- Critical Thinking
- Communication
- Health Insurance Authorization Process
- Health Insurance Benefit Verification
Timeline
Leave of Absence Coordinator
Sedgwick Claims Management Services Inc.
11.2022 - Current
Consumer Access Specialist (Temporary)
AdventHealth
09.2022 - 09.2022
Lab Registration Specialist (Temporary)
AdventHealth
07.2022 - 09.2022
Patient Registration Coordinator
Option Care
12.2019 - 06.2021
Center Support Specialst
Select Physical Therapy
02.2019 - 12.2019
Patient Service Specialist
Select Physical Therapy
03.2018 - 02.2019
High School Diploma -
Santaluces Community High School
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