Stephanie Hoss

• Oversaw insurance claims processing for pediatric home health services, ensuring timely and accurate submissions.
• Reviewed policy coverage and clarified benefits with clients and families to enhance understanding.
• Coordinated with healthcare providers to collect essential documentation for claims processing.
• Ensured compliance with state regulations and insurance guidelines throughout the claims process.
• Maintained organized records of claims and client communications for efficient retrieval.
• Trained new staff on insurance protocols and best practices to ensure adherence.
• Collaborated with interdisciplinary teams to improve service delivery strategies across departments.
• Managed denials, late payments, extensions, and other special circumstances through effective follow-up.

• Assisted CEO, HR, and Director of Quality Management with diverse administrative tasks.
• Managed insurance recertifications for Baylor facility to ensure compliance.
• Compiled expense reports for CEO to maintain accurate financial records.
  Piloted Ambassador Program to enhance corporate engagement initiatives.
• Ordered office supplies to maintain operational efficiency.
• Coordinated hospital-wide events and arranged lodging and transportation for staff during inclement weather.
• Nominated for Impact Award for exceptional contributions.
• Completed Leadership Development Program through Baylor Scott & White Rehab, enhancing leadership skills.

As a Patient Service Specialist:

• Completed new patient intakes.
• Verified insurance, verified neuropsych testing/counseling, started authorizations, and sent extension requests.
• Daily billing and reconciliation.
• Answering phone calls, managing the fax box, and distributing mail.
• Created various spreadsheets to streamline processes.
• Collecting daily copays, account balance reports.

• Evaluated claims progress using Alteryx, Excel, Outlook, OmniSYS, and Ui Orchestrator.
• Approved and denied diabetic supplies through Medicare for DME claims.
• Submitted paperwork to Medicare to ensure timely processing of claims.
• Coordinated with vendors to gather necessary documentation for billing efficiency.
• Provided nationwide internal support for Walmart and Sam's Club pharmacies.
• Analyzed patient progress notes to verify compliance with standards.
• Assisted in training new staff on billing systems and operational procedures.
• Collaborated with team members to develop process improvements.

• Conducted compliance calls and assisted pharmacists in completing Medication Therapy Management.
• Processed and filled prescriptions while managing drug orders efficiently.
• Submitted and followed up on prior authorizations with insurance providers.
• Maintained organized filing of end-of-date prescriptions and pharmacy documentation.
• Responded to incoming calls, addressing inquiries concerning insurance processing.
• Prepared marketing materials and coordinated in-store health events each quarter.
• Trained new employees, ensuring adherence to operational standards and practices.

• Assisted with MTM follow ups to patients, Medicare Star Ratings
• Created spreadsheets for out-of-state prescriptions to ensure accuracy and efficiency.
• Maintained and tracked medication inventory to uphold quality and integrity.
• Managed opening and closing procedures of pharmacy operations.
• Filed confidential documents to ensure compliance with privacy regulations.
• Inputted and filled prescriptions, processing drug orders for timely delivery.
• Marketed the pharmacy to gain business for senior living facilities

• Input and fill prescriptions, submit/ receive drug order
• Open and closed pharmacy
• Maintained quality, accuracy, and integrity of inventory
• Maintained and tracked medication inventory