Stacie Richmond-Owens
ATHENA,OREGON
Summary
Professional in healthcare administration with strong background in managing authorization processes. Adept at ensuring compliance, streamlining workflows, and mitigating risks. Consistent track record of fostering team collaboration and achieving results in dynamic environments. Skilled in navigating complex systems, prioritizing tasks, and maintaining high standards of accuracy and efficiency.
Overview
11
11
years of professional experience
Work History
Medical claims Team Lead
Moda Health, Inc.
08.2020 - 01.2024
- Assists the Supervisor and Claims Manager with daily operations
- Monitors and assists claim processors
- Provided help for any claims related issues
- Responsible for coordinating workflow, lead efforts in error reduction, and support team members with claim payment procedures
- Instructed others in processing procedures and/or provide general instruction related to claim adjudication
- Reviewed and applied the Plan policies and procedures as required for complex health benefit issues
- Demonstrated leadership ability by encouraging positive behavior and professionalism
Substitute Teacher
Various School Districts
09.2019 - 03.2020
- Responsibilities include student and classroom management, following lesson plans, and working one on one with students on various topics
- Work with confidential student information, record keeping, and emergency planning as needed
Human Resource Benefit Manager
Smith Frozen Foods, Inc
03.2016 - 08.2018
- Responsibilities include recruiting, hiring, and training of new employees
- Follow up with new hires with in the first week of employment to assure a smooth hiring process
- Developed and maintain online application process while keeping current job listings up to date
- First point of contact for production and administration staff who may have concerns or questions
- Other duties include manage employee schedules and time off requests as well as manage the Return-to-Work program for employees that are injured on the job
- Maintain current employee files
- Write and deliver disciplinary action forms
- Print, correct, and submit daily timecards to Payroll and process attendance exceptions
- Assure compliance to all policies and procedures
- Assist the HR Manager in investigations and compose 'Reports of Findings' as needed
- Preform all daily tasks required in the HR department
- Management of all benefits provided to both Administration and Union Employees
Medical Support Assistant
Department of Veteran Affairs
08.2015 - 03.2016
- Answered calls for the Primary and Pharmacy for many different regions, scheduled appointments, refilled medications, and assisted Veterans in any way
- Used an electronic medical record, multi-line phone, and a large verity of programs to help all callers
Authorization Specialist
Providence St. Mary Medical Center
11.2014 - 08.2015
- Worked with doctors, patients, and insurance companies to obtain referrals and authorizations as needed for medical care
- Gathered and documented information from internal and external sources while assuring confidentiality
- Worked with many electronic programs and office equipment through out the day
Patient Access Rep II
Conifer Health Solutions St. Anthony Hospital
03.2014 - 10.2014
- Work both the front desk and in the ER
- Position required to admit patients that come into the ER and for outpatient procedures, answer a multi-line phone, direct calls and visitors to provider offices and patient rooms, request and process all co pays and other payments as needed
- Provide Insurance verification and personal information as well as billing information
- Work directly with providers and nursing staff to provide the best treatment and experience to patients and their families
Coordination of Benefits Claim Processor
Pacific Source Health Insurance
01.2013 - 03.2014
- Process claims for Medicare members using Facets and other programs as needed
- Coordinate insurance benefit and speak with providers as well as members to obtain needed information
- Confirm accuracy on information within the Facets system and help maintain inventory to assure timely processing of members claims
- Assist in writing policies and procedures on proper processing steps and help in other areas as needed
Education
Bachelor of Science - Psychology
Eastern Oregon University
Skills
- Customer Focus
- Teamwork and Collaboration
- Prior Authorization Process
- ICD-10 Coding Familiarity
- Medical Terminology
- Medical Appeals Handling
- Authorizations
- Insurance Verification
- CPT coding knowledge
- Attention to Detail
- Documentation And Reporting
- Multitasking Abilities
Timeline
Medical claims Team Lead
Moda Health, Inc.
08.2020 - 01.2024
Substitute Teacher
Various School Districts
09.2019 - 03.2020
Human Resource Benefit Manager
Smith Frozen Foods, Inc
03.2016 - 08.2018
Medical Support Assistant
Department of Veteran Affairs
08.2015 - 03.2016
Authorization Specialist
Providence St. Mary Medical Center
11.2014 - 08.2015
Patient Access Rep II
Conifer Health Solutions St. Anthony Hospital
03.2014 - 10.2014
Coordination of Benefits Claim Processor
Pacific Source Health Insurance
01.2013 - 03.2014
Bachelor of Science - Psychology
Eastern Oregon University
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