Credentialed Trainer - Tapestry, Resolute Professional Billing & Hospital Billing, SBO, Scripps Community Connect, Cadence, Grand Central/Prelude.

I trained the employees coming into an AR position for the Business Office for Scripps Clinics and taught them the basics of our Practice Management Applications so that they could learn how to navigate through the system and understand it. I also taught soft skills classes and insurance classes.

I performed a variety of functions related to managed care customer service, which included but were not limited to: answering phones, detailed understanding of accurate billing information and claims processing, thorough research & process of provider disputes, compilation of information for submission of claims, follow-up with authorization team and health plans including referral status and appeals, collection of patient complaints, analysis of claim payment or denial trends, thorough review and analysis of patient accounts, enrollment and benefit verification.

I performed a variety of functions related to the admitting department, which included: in-patient admissions, insurance verification, out-patient registration, surgery pre-registration, lab registration, radiology registration, filing, issuing newborn medical record numbers, along with administrative support to other departments within the hospital.

I performed a variety of functions in the multiple roles I held which included: checking in patients, patient demographic updates, insurance verification, provided excellent customer service in a friendly, efficient manner,Experienced in coding, reviewed medical documentation in a multi-specialty setting, thorough understanding of all coding material (ICD-9/ICD-10, CPT, HCPCS) and their use in conjunction with CMS/Medicare regulations and other third party payers, knowledge of medical terminology, anatomy/physiology, demonstrated proficiency in the use of ICD-9/ICD-10 and CPT coding guidelines, ability to re-educate physicians on billing/coding guidelines, presented a professional work style, maintained confidentiality in all activities and possessed excellent oral and written communication skills, knowledgeable of computerized programs and data base usage. Knowledge of managed care customer service, answering phones, detailed understanding of accurate billing information and claims processing, thorough research & process of provider disputes, compilation of information for submission of claims, follow-up with authorization team and health plans including referral status and appeals, collection of patient complaints, analysis of claim payment or denial trends, thorough review and analysis of patient accounts, enrollment and benefit verification, assisting patients with appeals, pre-qualifying patients for Financial Assistance if criteria was met.

I performed a variety of functions related to the admitting department, which included: in-patient admissions, insurance verification, out-patient registration, surgery pre-registration, lab registration, radiology registration, filing, issuing newborn medical record numbers, along with administrative support to other departments within the hospital.

I performed a variety of functions related to the Pediatrics office, which included: answering phones, scheduling, checking in patients and checking out, insurance verification, filing, and nightly deposits.

I performed a variety of functions which included: Greeting customers, assisting with obtaining prescription/refill requests. I was responsible for all of the OTC ordering, verifying order was sent, priced all OTC items, and stocked order on the floor.