Michelle Kitchen
WILSON
Summary
Insurance Coordinator offering 17 years of experience within fast-paced, high volume environments. Highly competent in efficiently verifying, coordinating , processing insurance Precerts with insurance companies ,Preauthorizing Chemo Drugs / Scans and getting benefits on what we are doing with the pt, Skilled in quickly resolving issues and liaising between insurance providers, companies and policyholders. Contacting patients to let them know what they might be responsible for and helping look for copay assistance for the chemo drugs being distributed . Multi task well . Working in patients charts / documenting / scanning .
Overview
23
23
years of professional experience
Work History
Insurance Coordinator
Regional Medical Oncology Center
04.2006 - 12.2023
- Verified insurance and communicated coverage to staff and patients.
- Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
- Obtained prior authorization and precertification for outpatient procedures.
- Filed and tracked insurance claims and communicated claims status to patients.
- Maintained compliance with local, state and federal regulations governing insurance, Medicare and Medicaid requirements.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Maintained confidentiality of patient finances, records, and health statuses.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Communicated verification and authorization status updates with Billing department to facilitate decision-making for patient admissions and insurance coverage.
- Checked documentation for accuracy and validity on updated systems.
- Modified, updated and processed existing Precert
- Coordinated with contracting department to resolve payer issues.
- Determined appropriateness of payers to protect organization and minimize risk.
- Received faxes, imported , scanned into charts and distributing to the correct departments
- Work with chemo nurses to make sure chemo drugs been approved prior to getting treatments and make all changes as needed
- Entered and scheduled New Patients
- Keyed Hospital Charges for our providers that saw pts. in the hospital
Dialysis Technician
Gambro Healthcare
09.2000 - 03.2006
- Set up and operated dialysis machines for patients receiving treatment for kidney failure.
- Set-up equipment for dialysis and primed dialyzer in preparation for use.
- Performed routine quality control and safety checks on all equipment.
- Cleaned and connected fistulas, grafts and catheters to prevent infection.
- Measured and recorded patients' pre-dialysis and post-dialysis vital statistics.
- Followed directions when mixing dialysate and priming dialyzer with saline or heparinized solutions.
- Started and ended reverse osmosis water systems and completed water quality monitoring tests.
- Explained dialysis procedures to patients and answered questions and concerns prior to starting dialysis.
- Inventoried, ordered and restocked equipment and supplies needed for hemodialysis treatment.
- Explained dialysis procedures and hemodialysis machine operation to patients prior to treatment to ease anxieties.
- Safely transported, transferred and positioned patients on chairs for treatment.
- Monitored patient vital signs, lab results and other indicators of health.
- Educated patients about procedures, answered questions, and provided comforting words to control anxiety and enhance procedure results.
- Maintained accurate patient charts and medical records.
- Cleaned and sterilized instruments, equipment and surfaces.
- Gathered, charted, and analyzed patient history data and discussed key points with clinicians.
- Advised patients and families on health topics pertinent to care and treatment.
- Utilized medical software to document and track patient progress.
- Participated in hospital and clinic staff meetings to discuss patient care.
- Operated and maintained medical equipment used to diagnose and treat patients.
- Evaluated patient histories and medical records for accuracy and completeness.
- Monitored patients during treatments and identified specific response patterns.
Education
No Degree - Dialysis Technology
Wilson Technical Community College
Wilson, NCSkills
- Accounting Skills
- Multitasking
- Teamwork and Collaboration
- Eligibility Determination
- Data Entry
- Insurance Claim Forms Review
- Policy Modifications and Updates
- Reporting Skills
- New Policies Processing
- Paperwork Processing
- Billing Software
- Prior Authorization Processing
- Critical Thinking
- Organizing and Prioritizing Work
- Documentation Abilities
- Documentation Processing
- Appointment Scheduling
- Policy and Procedure Explanations
- Business Correspondence
- Coverage Determination
- Understanding of Medical Terms
- Insurance Coverage Verification
- Active Listening
- Information Verification
- Insurance Verification
- ICD-10 Coding
- Insurance Claims Processing
- Claims
- Decision Making
- Regulatory Compliance
- Insurance Knowledge
- Organizational Skills
- Computer Proficiency
- Data Analysis
- Risk Assessment
- Problem Solving
- Product Knowledge
- Training and Development
- Customer Service and Assistance
- Insurance Processes
- Payment Planning
- Medicare and Medicaid Knowledge
- Account Management
- Quality Assurance
- Claims Processing
- Customer Service
- Time Management
- Microsoft Office
Timeline
Insurance Coordinator
Regional Medical Oncology Center
04.2006 - 12.2023
Dialysis Technician
Gambro Healthcare
09.2000 - 03.2006
No Degree - Dialysis Technology
Wilson Technical Community College
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