Dynamic Medical Office Specialist with a proven track record at HCA Physician Services Group, excelling in patient scheduling and insurance verification. Recognized for exceptional customer service and attention to detail, I effectively manage medical records while ensuring HIPAA compliance, contributing to a streamlined healthcare environment. Committed to compassionate care and team collaboration.
I help ensure the smooth operation of our daily activities by maintaining and updating spreadsheets, managing incoming and outgoing calls, handling faxes, and providing prompt support to patients, providers, and clinical staff. I am also responsible for checking in, scheduling, and checking out patients. Our office serves as the main hub for seven locations, and I take pride in helping our team stay organized, efficient, and responsive to the needs of a busy healthcare environment.
Provide support for front desk operations, insurance verification, new patient intake, scheduling, and processing referrals. Responsible for scrubbing and submitting claims, including Medicare and Medicaid, managing second accounts receivable (2nd AR), handling medical records, balancing, and auditing patient accounts and credits.
I managed and maintained data for all newly enrolled students in the district, who speak a language other than English. Once a student was registered at a school, I visited the site and administered certified language proficiency testing to assess their English language level. Based on the results, I determined eligibility for ESL services, and helped ensure that appropriate support is provided at the student's designated school.
In this position, I was responsible for verifying each patient's insurance to ensure that an active and current policy was in place. For patients scheduled for upcoming appointments, I contacted insurance providers directly to verify specific coverage details, including drug administration (using ICD-9 and ICD-10 coding with appropriate modifiers), infusion time frames exceeding one hour, and same-day visits with a doctor or nurse. I also managed and maintained authorization requests through provider portals, ensuring all procedures requiring pre-approval had no lapse in coverage.
Beyond insurance verification and authorizations, I reviewed infusion claims and accounts receivables to investigate unpaid claims. I determined whether payments needed to be posted through accounting, or if appeals were necessary for claims not processed correctly, according to verified benefits or contracted fee schedules. My proactive approach ensured efficient billing processes and minimized delays in reimbursement.