Tameshia Gaston

Resolves patient accounts with possible insurance balances for CHS facilities. Contact patients as needed in regards to claims pending information from the member. Submit multiple request to facility regarding various issues such as coding review, medical records submission and adjustments for patient accounts to name a few. Proficient in use of SSI to review for claim processing, knowledgeable on how to read Explanation of Benefits from insurance companies. Files both appeals and reconsideration on patient behalf on those claims that may have denied by the insurance company.

• Hit monthly goals multiple times a year and received incentives
• multi-take various host systems
• answer inbound calls from patients questioning bills that have been received via mail.
• make outbound call to insurance companies
• utilize online access to check claim status while on hold
• Responded to customer calls swiftly to resolve issues and answer questions.
• Kept detailed records on individual insurance claims and incorporated into detailed client files.

• Acted as first point of contact and set appointments for prospective clients.
• Handled complaints and questions, and re-directed calls to other team members.
• Answered phone calls and answered questions from potential customers.
• Scheduled and confirmed appointments and meetings for senior management team.
• Liaison for hospital staff for registration and scheduling needs
• Managed physician scheduling template and logs
• In charge of entering patient demographics and first point of contact for patients being seen in the Orthopedics department
• Collected patient payments and collections accounts
• Managed daily clinic preparation process
• Verified patient medical insurance and verified for accuracy
• Proficient use of Microsoft Windows office, email, Hyperspace, Epic, Old Text Epic, Wiz Orders, MEDIPAC, PIMS and Star panel
• Compliance with JCAHO/HCFA policies