Yvette McCullough
Shreveport,LA
Summary
Seeking a challenging career in the Business/ Healthcare Industry, which will allow me the opportunity to fully utilize my related experience, educational training and proven abilities offering me the opportunity for personal, financial- professional growth. Highly motivated and committed Medical Assistant with proven history of superior performance at individual, team and organizational levels. Multitasks and prioritizes workloads with little or no supervision. Detail-oriented professional looking to bring medical background and team-building skills to deadline-driven environment.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Advance Medical Support Assistant
United States Department of Veterans Affairs
02.2023 - Current
- Coordinates with the patient care team to review the clinic utilization by using various reports to ensure that the clinic setup is closely monitored to effectively support the needs of the clinic and make any necessary adjustments
- Develop /maintain effective and efficient communication with the patient, interdisciplinary team, VA Medical Center, and other agencies
- Completes all scheduling actions, to include consult management, in accordance with VHA Directive 1230 /OP Scheduling Processes and Procedures, providing Extraordinary Customer Service and Patient Care by telephone and in hospital /clinical office settings
- Routinely displays courteous and professional behavior which provides a professional image of Overton Brooks VA Medical Center and take actions to effectively solve problems before they have an adverse impact of veterans, the organization, or the other employees
- Participating in team huddles and team meetings to manage and plan patient care
- Setting priorities and deadlines, adjusting the flow and sequencing of the workflow to meet team and patient needs
- May work with the team to reinforce the plan of care and self-help solutions and entering appropriate information into the electronic record
- Monitoring pre-appointment requirements to assure readiness for patient visits/ procedures (e.g., x-ray, lab work)
- Managing electronic wait list to verify and validate accuracy and resolve issues
- Participating and providing input in problem solving on operational issues or procedures in team meetings, performing administrative follow-up action items
- Participating in and independently follow-up on team huddles by sharing information and collaborating with the medical team to assure continuity of care
- Evaluating patient information and clinic schedule lists to determine whether patient is vested
- Educating providers about shared patients (those who receive their care at multiple VA’s or those who have care in the community) and bringing to the attention of the provider
- Records telephone messages pertaining to matters such as detailed laboratory reports, x-rays, test results; and recognizes and refers urgent messages to the clinical staff for immediate actions
- Set up suspense files necessary for processing orders for recurring tests, etc
- Receives and handles most caller, both personal and telephonic; assist patients by contacting volunteers or social workers as needed, and veteran representatives
- Coordinate and schedule return appointments and consults for follow-up /OP treatment
- Interprets and process a wide variety of provider orders for /IP and /OP to include requests for diagnostic tests, medications, treatment activities
- Participating in daily team huddles and team meetings to manage and plan patient care
- Assisting providers with needed medical records and shared information needed for health system’s patient care in the clinic setting
- Other duties as assigned.
PASER
Willis-Knighton Health System
02.2019 - 02.2023
- Coordinates with a team of physicians, managers, nursing staff and clerical staff as an integral component, assisting with the daily operations of the /OP clinics
- Provides excellent customer service during patient admissions in and out for scheduled and non-scheduled appointments
- Verification of insurances, filing and data entry
- Demonstrate a strong work ethic, flexibility, dependability, possess excellent communication skills, have a solid knowledge of computers, and have the initiative to work independently
- Schedule patient appointments for consultation
- Schedule follow-up appointments
- Ensure the accuracy and completeness of daily registration
- Meet deadlines while ensuring compliance with process and policies
- Verify patient insurance coverage, collect co-pays, deductibles, and co-insurance payments
- Post payment
- Scan documents pertaining to patient medical records into electronic charts to ensure a higher level of quality service and privacy to patients.
Patient Advocate / Patient Access Representative
Ochsner LSU Health- Shreveport
02.2017 - 02.2019
- Provide basic and fundamental non-professional nursing assistance, clerical duties, patient registration /admission for patient care, excellent customer service and quality comfort
- These duties were performed in conformance with nursing planning of care in accordance with hospital policy and procedures
- Function as clerical support for assisting nursing with patient care in the care units, level 1 trauma care, psychological /mental health care with emphasis to maintain quality care, communication with staff, Shreveport Police Department, Shreveport Fire Department involved with patient care to also provide continuity care in accordance with HIPAA.
Customer Service Representative / Insurance Verification Rep
Specialist Hospital Shreveport
07.2013 - 07.2017
- Under the direction of the Business Office Manager, Customer Service Representative, and the Insurance Verification Representative is responsible for following up directly with commercial and government payers to resolve claims issues/ denials and secure appropriate and timely reimbursement
- Researches and analyzes denial claims, follows up and formulates resolution
- Submit appeals and reconsiderations on claim rejections, underpayments, and denials
- Engages the coding follow-up team for any medical necessity or coding related appeals
- Initiates insurance follow-up on aged, unresolved claims to ensure maximum reimbursement
- Set follow-up activities based on the status of the claim
- Communicates identified payer trends such as denials for specific procedure or diagnosis codes, or other identified issues
- Researches and responds to documentation requests from insurance carriers in a timely manner
- Communicates with patients and necessary parties to resolve issues relating to payment
- Submits adjustments to account balances identified through payer
- Documents clear and concise activities performed in system from each account worked
- Processed liability quotes / Lien letters for all liability cases
- Verified that patients had the prior insurance coverage prior to any procedures or appointment scheduling
- All other duties as assigned.
Patient Access Services II
CHRISTUS Highland Medical Center
04.2000 - 06.2013
- Provide basic and fundamental non-professional nursing assistance, clerical duties, patient registration /admission for patient care, excellent customer service and quality comfort
- These duties were performed in conformance with nursing planning of care in accordance with hospital policy and procedures
- Identify, research, verify various insurance plans benefit coverage, update, and collect patient personal demographic information for patient pre-registration
- Obtain patient, legal guardian, family member or power of attorney signature for hospital and clinic prior authorization
- Collect and scan documents (Insurance cards, Identification cards, Physician orders, Referral, Proof of income and other patient documents)
- Accurately document information via EPIC (Hospital Computer System) Clinic Appointment and Pre-Admission
- Research and resolve pending issues of patient liability (Deductible /Co-pays)
- Update and resolve benefits collections for balance or amount due at admission /discharge of the date of service
- Obtain /IP and /OP referral/ pre-certification authorization approval for medical care
- Submit and obtain prior authorization request from insurance companies for (Echo, CT/PET, MRI, Ultrasounds, Pap screening, Biopsy and Circumcision)
- Provides a channel through which patients can seek solutions to problems, concerning, resolving needs, recognizing that complaints are a gap between service expectations and the actual experience of the patient
- Provides communication to clinical staff, physicians, residents or nursing regarding approval, denial or request for additional information needed to obtain prior authorization
- Responsible for In-bound and out-bound hotline telephone calls to be transferred to departments of the hospital
- Cancel and re-schedule appointments upon patient request
- Provides extraordinary customer service to patients, guests, visitors, and fellow employees
- Ensure patients and visitors are aware of CHRISTUS Health Medical Center policy and procedures- providing options for patient liabilities of insurance coverage of self-pay, private-pay, of financial responsibility that is due
- Refer patients to Financial Counseling for Financial Assistance, Free Care and Charity Care Assistance Programs (Medicare and Medicaid Services)
- Responsible for performing/ following and maintaining the quality assurance and safety process of CHRISTUS Health Medical Center policy and procedures.
Education
High School Diploma -
Green Oaks Performing Arts Academy
Shreveport, LA05.1984
Skills
- Medical terminology proficiency
- Patient scheduling abilities
- Medical record assessment
- Understanding of privacy regulations
- Insurance company procedures understanding
- Patient Communication
- Microsoft Office
- HIPAA Compliance
- Multi-tasking
- Medical software
- Vital signs monitoring
- File Management
Certification
Certified Notary Public, 05/1994
References
Reference will be provided upon request.
Timeline
Advance Medical Support Assistant
United States Department of Veterans Affairs
02.2023 - Current
PASER
Willis-Knighton Health System
02.2019 - 02.2023
Patient Advocate / Patient Access Representative
Ochsner LSU Health- Shreveport
02.2017 - 02.2019
Customer Service Representative / Insurance Verification Rep
Specialist Hospital Shreveport
07.2013 - 07.2017
Patient Access Services II
CHRISTUS Highland Medical Center
04.2000 - 06.2013
Certified Notary Public, 05/1994
High School Diploma -
Green Oaks Performing Arts Academy
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