AMSA (Advanced Medical Support Assistant) - Battle Creek VA Medical Center
(2023-05)
- Receives/Reviews all claims received.
- Ensures accurate and timely scheduling/rescheduling of appointments.
- Checks emails periodically throughout the day.
- Monitors provider call-offs and reschedules appointments as necessary.
- Communicates with the Veteran Service Representatives to obtain clarification regarding any claims with discrepancies.
- Monitors/Cancels and No-Shows any missed appointments.
- Monitors/Answers Team messages appropriately.
- Monitors Streem Fax for incoming faxes, medical documents, etc.
- Send outgoing faxes at the request of medical providers to obtain veteran medical records.
- Orients and provides on-the-job training for new and current employees.
- Alphabetically files claim daily.
- Prints next day appointments for providers.
- Participates in daily huddles and monthly team meetings
- Mails appointment letters/instructions to all scheduled veterans.
- Distributes, balances workload and tasks assuring the timely accomplishment of work assigned.
- Develops and/or maintains effective and efficient communication with the veteran's, interdisciplinary team, VA Medical Centers, and other agencies.
PSE Clerk - United States Postal Service - Frisco, TX/Lafayette, LA/Kalamazoo, MI
(2019-09 - 2023-05)
- Preparing mail/packages to load into carrier trucks.
- Loading postal trucks and making sure to pack parcels in delivery route order.
- Loading and operating machinery for mail processing, sorting and canceling.
- Sorting and organizing mail to be delivered.
- Unloading mail trucks after they complete their routes.
- Repairing machines if necessary
- Bundle, label and route mail depending on their destinations, and according to established deadlines and procedures.
- Operating optical character readers such as scanning equipment, address graphs and mimeographs.
- Assisting customers.
- Repairing packages that have been broken or otherwise damaged.
- Checking items' addresses to make sure they are legible and correct.
- Placing mail on conveyors to be culled and sorted.
- Weighing parcels to determine what the postage costs.
- Operating forklifts, pallet jacks and trains to move large boxes and mail items.
Patient Care Coordinator/Optometric Assistant - MyEyeDr
(2019-03 - 2019-09)
- Schedules and coordinates appointments for patients in the optometric clinics, ensuring all treatment requested by the physicians has been scheduled, and rescheduling appointments when necessary
- Requests Medical Records from the appropriate authorities
- Ensures appointments are timely and in accordance with physician's request
- Enters, and retrieves information and data from the computerized system
- Coordinates scheduling to avoid conflicts with clinic schedule
- Collaborates, communicates, sets priorities, and organizes work to meet deadlines, ensuring compliance with established processes, policies, and regulations
- Providing direct support to our Doctor of Optometry in preparing the patient for their visit inclusive of preliminary testing and measurement
- Contacts patients to coordinate follow-up care
- Communicates effectively both orally and in writing, to meet program objectives
- Consults with patients, accurately document existing conditions and complaints, and chart medical history to prep for Optometrist exam
- Completes requested forms, using automated systems, for individual patient orders and other requests as required.
- Maintains a smooth flow of patients to the Doctor and additional office staff throughout appointment
- Ensure patients are comfortable with office procedures to which they will be exposed during appts
- Operates all pretest equipment to perform a range of visual screenings for patients prior to visiting with the doctor
- Conducts contact lens training for applicable patients and other preliminary testing
- Participates in and independently follows up on team huddles by sharing information and collaborating with the office staff and physicians to ensure the continuity of care.
Recovery Specialist/Revenue Cycle - Benefit Recovery Services - Houston, TX
(2016-03 - 2019-03)
- Assist customers by verifying billable insurance information.
- Provides pre-registration and outpatient billing.
- Provides client services for commercial Hospitals, Hospital Corporations, Veterans Administration Medical Centers and the United States Air Force.
- Obtains claim status via telephone calls or using insurance carrier websites.
- Processes/Reprocess claims using the UB04 and CMS 1500 Forms.
- Interacts with providers and hospitals to obtain medical records/documentation, pre/retro authorizations, etc.
- Submits appeals on behalf of members for denied/non-paid medical claims.
- Follows HIPAA Compliance and uses ICD-9, ICD-10, HCPCS Codes, and Advanced Medical Terminology when applicable.
Customer Service Representative - Maximus Healthcare - Manpower Agency - Irving, TX
(2015-09 - 2016-03)
- Accurately performs data entry to ensure that customer inquiries are entered adequately and efficiently. Receives and enters authorizations, consultations and medical documentation from the Veteran's Affairs office to locate providers to schedule, change or add appointments for veterans.
- Escalates unresolved customer issues to the appropriate department for resolution.
- Reviews client medical documentation for accuracy. Works independently and alongside team members to meet deadlines.
Appeal and Grievances Analyst - United Healthcare
(2013-03 - 2015-09)
- Responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of medical claim appeals and grievances.
- Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions. Analyzes and identifies trends for all appeals and grievances. May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providers.
- Utilizes ICD-9/10 codes, CPT codes and medical terminology to handle appeal cases.
Dental Assistant/Assistant Floor Supervisor - Smile Best Dental & Orthodontics
(2012-09 - 2013-03)
- Sets up operatories before each procedure
- Provides chair-side assistance for specific clinical procedures for Dentist/Hygienist
- Assists Dentist/Hygienist with Dental and Periodontal Charting
- Practices sterilization techniques
- Takes impressions of patient's teeth
- Utilizes proficient knowledge of digital radiology to take digital x-rays
- Assists Orthodontist with procedures
- Administers Zoom (teeth whitening) treatments for patient's
Benefits Coordinator/Admissions Representative - Caremark Specialty Pharmacy | Irving, TX
(2007-02 - 2008-07)
- Responsible for validating the demographic and reimbursement information for Growth Hormones, Rheumatoid Arthritis and Psoriasis. Verifies benefits for all medications dispensed from the 17 network pharmacies.
- Collects copayments and deductibles. Verifies and communicates benefit information to clients and doctor's offices.
- Communicate with several sales organizations regarding contract and physician issues.
- Receives closures of all referrals received within a 24-to-48-hour period.
- Identifies issues/problems and escalates those problems for resolution.
Resolution Specialist - Medco Health Solutions - Irving, TX
(2006-03 - 2007-02)
- Interfaces with Customer Service Representatives, Client Services, Pharmacists, Doctors and Eligibility departments via telephone calls and written correspondence.
- Analyzes and makes recommendations concerning existing methods of resolving client problems.
- Determines what research is required to resolve member complaints and communicate effective instructions to appropriate representatives to ensure expedient service while maintaining a high level of quality and productivity.
- Medicare D related inquiries including explanation of plan design, coverage stages, enrollment, explanation/coordination of benefits and plan restrictions, etc.
- Provides informational support for new hire trainees.
Customer Service Representative - Medco Health Solutions - Irving, TX
(2005-09 - 2006-03)
- Aids members by inputting customer information into a computer database to order/refill prescriptions, making sure that all the needs of each member are met.
- Identifying and clarifying issues through effective questioning and listening skills.
- Communicating with customers and clients using Medco Health's telecommunications systems in a web-based computer environment.
Customer Service Representative - GEICO - Dallas, TX
(2005-03 - 2005-08)
- Aids each customer needing insurance policies.
- Assists each customer with insurance quotes, payments, adding/deleting vehicles, and adding/deleting persons from the policy, changing/updating information in the computer database, faxing appropriate information to lien holders or dealerships, verifying coverage for the policyholder, rating each policyholder with the correct rates, and providing the best rates possible for each customer calling in.
Fitness Technician/Manager - CURVES FOR WOMEN - Bonaire, GA
(2004-08 - 2005-06)
- Assisted customers (women) with weight loss needs by helping them with weight loss, diets and exercise plans.
- Relayed information to each customer about products via telephone or by appointment.
- Managed a staff of 5 fitness technicians.
- Set appointments, filed paperwork, entered information into the computer database and answered phones.
- Assisted each customer by taking measurements monthly and updating the information in each file and in the computer database.
- Managed reports on each daily transaction and deposited daily earnings into a bank account.
Emergency Road Service Technician - GEICO - Macon, GA
(2004-07 - 2005-03)
- Provided policy holders calling in needing assistance with disabled vehicles by locating appropriate services, ranging from gas, tire changes, towing and jump starts.
- Located necessary providers for these policy holders by selecting the provider with the best Estimated Time of Arrival (ETA).
- Entered information into a computer database and made outbound calls to policyholders to check on the status, if necessary.
Logistics Analyst - UNITED STATES AIR FORCE - Various Worldwide Locations
(1997-07 - 2002-11)
- Supervises and performs item and monetary accounting and inventory stock control, financial planning, and funds control.
- Computes requirement, determines allowance, researches and identifies supplies and equipment requirements.
- Supervises and performs operations involved in storage, inspection, identification, and receipt of property.
- Responsible for facility safety and security and HIPAA Compliance.
- Conducts inventories, Operates automated equipment, special purpose government vehicles, and material handling equipment.
