* Management of EHR professionals and departmental projects. * Lead weekly informational meetings with team and stakeholders to discuss and prioritize projects and development of EHR and ancillary applications. * Develop organizational roadmaps for long-term projects including patient portal, system upgrades, health information exchange, and ePrescribe. * Manage technology vendors and EHR budgets * Implement and control MACRA/MIPS requirements to ensure organizational compliance. 1 * Mentor team members to support employee development.
- EHR Manager at Laser Spine Institute
- Business Analyst at Laser Spine Institute
- Clinical EMR Analyst at Laser Spine Institute
- Medical Screening Processor at Laser Spine Institute
1 year, 3 months at this Job
- Master of Public Health - Toxicology and Risk Assessment
- Certification in Public Health
• Successfully managed a team of 5 employees. Lead by example and assisted teammates when needed.
• Reviewed representatives' accounts for quality, to ensure claims/accounts were worked entirely and the correct actions were taken.
• Worked special projects issued by Manager and Directors.
• Assists with orientation and training of new employees..
• Reviewed high dollar adjustments and took proper action when needed, whether completing the adjustment or sending appeal.
• Responsible for reviewing and approving of refunds.
• Review team performance and effects changes as needed to improve processes and services.
• Monitors and approves team member's timecards and PTO requests in ADP
• Worked with third-party companies such as Zelis and Multiplan on negotiations to resolve accounts APPEALS SPECIALIST
• Review, maintain, and update the status of pending insurance claims through direct calls to the insurance carrier along with internet websites.
• Review medical records against the CPT codes billed to ensure that claims were properly billed out.
• Review refund requests. Make decisions whether to approve or deny the refund by way of submitting an appeal.
• Review claim denials and take the appropriate action to obtain payment. This may include sending medical records, sending reconsiderations, or sending appeals.
• Research low payment claims in order to take action for a higher reimbursement. PRECERT SPECIALIST
• Reviewed clinical data and matched it against medical terms, diagnoses and/or procedure codes. Followed established procedures to authorize a request or refer a request to leadership for further review.
• Tracked, obtained and extended authorizations from various carriers (i.e. UHC, Medicare Replacement, etc.) policies in a timely manner.
• Responded quickly and professionally to e-mails, calls, questions, and concerns.
- TEAM LEADER ACCOUNTS RECEIVABLE at LASER SPINE INSTITUTE
- DOCUMENTATION REVIEW SPECIALIST at LINCARE
3 years, 6 months at this Job
- Account Executive at Greenway Health
- Patient Coordinator at Laser Spine Institute
- Medical Intake Skills Manager at Laser Spine Institute
- Consult Admin Scheduling Team Lead at Laser Spine Institute
1 month at this Job
- Bachelors of Science degree - Marketing
• Plans and coordinates the development, implementation, and execution of subprograms, special projects, and other initiatives designed to achieve the overall mission, goals, and objectives of the program
• Assisted with overflow tasks in different departments
• Worked with Chief Medical Officers to gather information requested on patients
• Physician Liaison for new medical division
- Project Coordinator at Sono Bello
- Consult Specialist at Laser Spine Institute
- Spine Care Coordinator at Laser Spine Institute
- Consult Specialist at Laser Spine Institute
8 months at this Job
- Bachelor of Science - Hotel Restaurant and Institutional Management
• Manage a high volume of calls and chats simultaneously
• Identify patients' needs for a quality customer experience by providing information or connecting them to the correct department and/or their Spine Care Consultant
• Acquire and provide product/service information to patients in a timely manner
• Create new patient records, as well as manage existing patient information in Salesforce
• Communicate with fellow team members and managers on a daily basis to by living and promoting the CHOICE values system
- Customer Care Representative at Laser Spine Institute
- Bartender, Waitress, Certified Trainer at Hooters
1 year, 7 months at this Job
- Bachelors of Arts - Marketing
- General AA
Transcribing spinal surgical reports using Fusion and NextGen software. Editing voice recognition spinal surgical reports. Current schedule is 7:30am-4pm Monday-Friday.
- Transcriptionist at Laser Spine Institute
- Medical Transcriptionist-Clerk at TriHealth Laboratories
5 years at this Job
- Associate of Arts
* Train and mentor all new Medical Record Specialists * Identify trends in metrics and processes and provide suggestions for improvement * Provide excellent customer service to internal and external customers * Strong commitment to exceeding goals and deadlines with a focus on quality customer service * Order medical records via phone, fax and/or letters as requested by our business partners * Fax, email and mail secure patient medical records * Process patient, disability, and continuation of care requests
- Medical Record Specialist at Laser Spine Institute
- ROI Medical Record Specialist at CIOX Health
1 year, 9 months at this Job
- Bachelor's Degree in Business Management - Business Management
- High School Diploma
Worked with Executive Directors and Vice President to on-board Spine Care Consultants, Medical
Assistants and Spine Care Coordinators to train and implement Salesforce across the enterprise.
• Cross-trained to in multiple critical roles including Consult Specialist, Consult Medical Assistant, Scheduling Coordinator and Associate Executive Director.
• Traveled to all seven facilities across the U.S. to consult and meet face-to-face with patients to discuss surgical candidacy and the patient process.
• Connected and gained trust from prospective surgical candidates to move forward with Laser Spine Institute's minimally invasive spine surgery.
• Reviewed insurance benefits, discussed financial responsibility and provided options for financing.
- Traveling Spine Care Consultant at Laser Spine Institute
- Senior Spine Care Consultant, Tricare at Laser Spine Institute
- Spine Care Consultant at Laser Spine Institute
2 years, 6 months at this Job
• Coordinated with surgeons and clinical providers to schedule surgical and diagnostic procedures
• Obtained necessary medical records from previous physicians.
• Obtained authorization for surgical and diagnostic procedures.
• Performed business meeting with patients to discuss insurance coverage and payment options.
- Patient Coordinator at Laser Spine Institute
- Hospitality Associate at Laser Spine Institute
- Customer Service Professional at Fifth Third Bank
1 year, 6 months at this Job
- Associate of Applied Science - Medical Office Technology
MRI REVIEW DOCUMENTATION (TRANSCRIBER) LASER SPINE INSTITUTE
• Documented all MRI/CT pertinent findings for all potential patients into systems evaluation sheet.
• Transcribed conditions treated surgically by Laser Spine Institute to findings that ruled out a patient as a potential candidate.
• Obtained all Latin reports and translated the reports from Spanish to English.
• Maintained Productivity with 130 reports transcribed daily and no less than 90% quality accuracy.
• Assisted the dial team with contacting medical facilities and hospitals to obtain patient imaging reports. INSURANCE VERIFICATION PRECERTIFICATION SPECIALIST LASER SPINE INSTITUTE
• Pulled all assigned insurances accordingly, based on scheduled date of service and medical policy criteria.
• Verified all insurance eligibility, co-pay, co-insurance, deductible and prior notification requirements.
• Reviewed all clinical information to ensure they were completed and signed by physician.
• Submitted authorizations and pre-determinations request based on insurance criteria and date of surgery.
• Correlated with outside departments to reach new goals on policies and procedure guidelines. ELIGIBILITY AUTHORIZATION REPRESENTATIVE PARK PLACE MRI
• Managed pre-certification department by providing direction and leadership with the management team.
• Worked with various insurance companies to obtain eligibility and procedure authorizations.
• Placed outbound calls to providers to obtain patient records pertinent to scheduled modality.
• Advised all patients on out of pocket responsibility via-phone prior to appointments, and answered all questions pertaining to insurance.
• Attended weekly meetings with the marketing team to providers offices to advise on clinical information process and have new contracts signed. FULL ACCESS REPRESENTATIVE STERN, DRAKE, ISBELL & ASSOCIATES
• Checked in - out all patients in a prompt and professional manner.
• Verified insurance eligibility and ensured all prior notifications were obtained.
• Collected all co-payments, co-insurance, deductibles, and self-pay responsibilities at time of service.
• Scheduled patients in person and via-phone based on schedule availability, insurance type and modality.
• Advised all patients at time of being scheduled to be NPO if applicable and or to follow certain protocol instructions based on scheduled modality. GREETER PATIENT SERVICE INSURANCE VERIFICATION SPECIALIST CAREVIEW/ TOWER DIAGNOSTIC CENTER
• Started as a front desk greeter answering a 15-line multi phone system in addition to directing all patients and visitors upon entering the building.
• Checked in all patients based on scheduled appointment time, entered all patient data information and scanned RX, ID and insurance card (s).
• In 2005 I learned how to correlate scheduled appointments and the different types of insurances based on medical policy criteria's.
• Responsibilities then changed to insurance verification and prior notifications based on patient appointments dates and modalities.
• Assisted management team with the patient questionnaire paperwork translation from English to Spanish.
- MRI REVIEW DOCUMENTATION at Laser Spine Institute
4 years at this Job