Trevor Burris
Berea,KY
Summary
Seasoned Referral Coordinator/ Medical Insurance Specialist with proven background in navigating complex insurance claims, policy interpretation and patient advocacy. Strengths lie in deep understanding of medical coding, billing procedures and regulatory compliance. Notable impact made in previous roles by improving accuracy of claims submissions to reduce denials and expedite payments. Possess strong interpersonal skills for effective communication with healthcare providers, insurers and patients.
Overview
4
4
years of professional experience
2015
2015
years of post-secondary education
Work History
Referral coordinator/Medical Insurance Specialist
Baptist Health Medical Group
Richmond, Kentucky
10.2024 - Current
- Process and submit patient claims to insurance providers, including detailed CPT/ICD coding and documentation for medical necessity, consistent with standards seen in PIP claims.
- Managed the office’s insurance claim queue, including billing and coding for patient visits, filing documentation for motor vehicle accidents and workers’ compensation cases, and ensuring all claims were processed efficiently for timely payouts to insurers and patients.
- Communicate with insurance adjusters and claims representatives to clarify billing, resolve disputes, and respond to denials or additional documentation requests.
- Coordinate all incoming and outgoing referrals while relaying all information and documentation to insurance, the PCP, the receiving referral office, and the patient.
- Hands-on experience with medical claims processing in a high-volume clinical setting
- Familiar with medical billing practices aligned with PIP claim requirements
- Collaborated with insurance carriers on claim resolution.
- Reviewed demographic, clinical and insurance information before sending to referred specialists.
- Adhered to HIPAA regulations when handling confidential records
- Participated in biweekly claim work queue meetings, focused on ongoing training and implementing strategies to improve Auto claims and workers’ compensation.
Patient Access Coordinator
Baptist Health Medical Group
Richmond, KY
11.2023 - 10.2024
- Coordinated patient registration and scheduling for multiple departments.
- Reviewed insurance information and verified eligibility for services.
- Assisted patients in completing necessary forms and documentation.
- Applied HIPAA privacy and security regulations while handling patient information.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Organized and maintained records by updating and obtaining both personal and financial information from patients.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Verified insurance eligibility and ensured coverage of services to be provided.
- Assisted in obtaining prior authorizations from insurance companies.
- Collected payments for services rendered and processed credit card transactions accurately and efficiently.
- Provided financial counseling services to patients regarding payment options.
Customer Service Team Lead
Walmart
Richmond, KY
08.2021 - 11.2023
- Supervised daily operations of customer service team to ensure smooth workflow.
- Trained new employees on customer service protocols and company policies.
- Assisted in resolving complex customer issues through effective communication techniques.
- Monitored team performance metrics to enhance service quality and efficiency.
- Utilized claims management software to track and document case progress.
- Maintained organized records of claims for future reference and audits.
- Established positive rapport with customers, managers and customer service team members to maintain positive and successful work environment.
- Responded to phone and online customer service requests within designated turnaround time to improve customer satisfaction ratings.
Education
Rockcastle County High School
Mt Vernon, KYSkills
- Medical coding
- Insurance verification
- Prior authorization
- Attention to detail
- Effective communication
- Team leadership
- Pre-authorizations
- Notetaking and documentation
- Insurance precertification processes
- Claims processing
- Insurance claims review
- Claims investigation
- Claims trend analysis
- Coverage determination
- Insurance regulations
- Workers compensation
- CPT/ICD coding
- Risk assessment
- Claims handling
Timeline
Referral coordinator/Medical Insurance Specialist
Baptist Health Medical Group
10.2024 - Current
Patient Access Coordinator
Baptist Health Medical Group
11.2023 - 10.2024
Customer Service Team Lead
Walmart
08.2021 - 11.2023
Rockcastle County High School