Angela Mccathern
Pageland
Summary
Dynamic Veteran Referral Coordinator at Virta Health with expertise in insurance verification and patient scheduling. Proven ability to enhance patient satisfaction through efficient referral tracking and exceptional communication skills. Committed to process improvement and compliance with HIPAA regulations, ensuring seamless transitions in patient care and accurate documentation.
Overview
10
10
years of professional experience
Work History
Veteran Referral Coordinator
Virta Health
11.2024 - Current
- Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
- Maintained a high level of accuracy in referral documentation, ensuring smooth transitions between healthcare providers.
- Processed referral requests from patients, doctors and other health care professionals.
- Responded to patient inquiries to offer timely updates regarding referral status.
- Served as a liaison between primary care physicians, specialists, and patients to ensure timely access to needed services.
- Managed electronic health records efficiently, safeguarding sensitive patient information while expediting the referral process.
- Provided exceptional customer service, addressing patient concerns and inquiries regarding the referral process.
- Developed and maintained strong working relationship with referral sources to streamline processing.
- Established strong relationships with external providers, facilitating seamless communication and collaboration in patient care.
- Developed comprehensive knowledge of insurance requirements, advocating for patients when necessary to secure approval for needed services.
- Kept healthcare providers informed of referral status updates, promoting optimal continuity of care throughout the referral process.
- Enhanced patient satisfaction with timely coordination of referrals and appointments.
- Assisted with completion of referral forms and verified data accuracy and completion
- Monitored referrals to foster timely completion and followed up with physicians to facilitate.
- Facilitated referrals to other healthcare providers and resources to bridge service gaps.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Streamlined referral process by implementing efficient tracking and communication systems.
- Improved departmental workflow by assisting colleagues with tasks such as appointment scheduling or insurance verification when needed.
- Provided thorough follow-up support after completion of referred services, ensuring proper billing procedures were followed.
- Attended continuing education courses to stay current on referral processes and best practices.
- Implemented tracking system for referral outcomes, enabling continuous improvement of referral process.
- Contributed to patient education by providing relevant information about their referral process and expectations.
- Maintained accurate and up-to-date patient records, contributing to improved healthcare outcomes.
- Optimized use of healthcare resources by efficiently managing referral appointments and follow-ups.
- Communicated with patients, ensuring that medical information was kept private.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
Behavioral Health Scheduler
Tria Federal
11.2023 - 10.2024
- Reduced scheduling conflicts and ensured timely execution of tasks through proactive rescheduling and resource allocation adjustments.
- Maintained high levels of customer satisfaction through diligent scheduling coordination, ensuring all deliverables were met within agreed timeframes.
- Consistently met deadlines by effectively allocating resources, tracking progress, and making necessary adjustments to schedules as needed.
- Worked with supervisors and team members to understand supply needs and bring levels within desired tolerances.
- Facilitated smooth handovers between shifts by creating comprehensive documentation of completed tasks and pending items for follow-up action.
- Identified best practices within the scheduling function, sharing these insights across teams to drive continuous improvement efforts.
- Established and maintained strong working relationships with both internal and external stakeholders, facilitating open communication channels for improved collaboration.
- Facilitated training sessions for junior schedulers, elevating team capabilities and performance.
- Improved communication with veterans by providing empathetic listening and clear explanations of benefits and procedures.
- Achieved high level of customer service satisfaction ratings by promptly answering inquiries from veterans regarding their cases via phone calls or email correspondence.
- Promoted positive relationships among coworkers fostering a supportive work environment where team members could collaboratively address challenges faced daily.
- Developed personalized action plans for veterans addressing their unique needs, resulting in higher satisfaction rates.
- Ensured compliance with all applicable laws, regulations, policies while managing sensitive information about veteran''s personal data securely.
- Maintained up-to-date knowledge of federal regulations, policies, and procedures related to veteran benefits administration.
- Coordinated with different service providers to meet clients' individual needs.
Patient Access Representative
Ortho New York
03.2021 - 11.2023
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
- Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
- Maintained accurate patient records, contributing to a well-organized database for seamless information access across departments.
- Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
- Improved patient satisfaction scores by actively addressing concerns and providing prompt assistance during the check-in process.
- Collaborated with healthcare providers to ensure timely appointment scheduling and coordinated follow-up care for patients'' needs.
- Enhanced departmental collaboration by regularly liaising with medical, nursing, and administrative staff on pertinent patient matters.
- Increased efficiency in managing high call volumes by developing effective phone triage techniques for prioritizing urgent matters.
- Reduced patient anxiety, providing clear explanations of procedures and addressing concerns compassionately.
- Maintained high standards of confidentiality and privacy, strictly adhering to HIPAA regulations.
- Streamlined appointment scheduling for optimal clinic flow, reducing wait times significantly.
- Achieved high levels of accuracy in patient data entry, minimizing errors and enhancing record reliability.
- Supported clinical staff by preparing accurate patient documentation and records ahead of appointments.
- Improved operational efficiency, organizing patient documentation and streamlining access to information.
- Assisted in reducing no-show rates by implementing reliable follow-up and reminder system for appointments.
- Increased patient trust and satisfaction, delivering empathetic support and guidance throughout their visit.
- Enhanced data accuracy with meticulous verification of patient information and insurance details.
- Boosted team morale and productivity by sharing knowledge and best practices in patient access processes.
- Enhanced patient experience, ensuring welcoming environment from first point of contact.
- Enabled better patient care with thorough pre-visit preparations and clear communication of patient needs.
- Facilitated smoother patient visits, coordinating with healthcare providers to ensure timely service.
- Improved patient satisfaction by efficiently managing registration and intake processes.
- Verified patient insurance eligibility and entered patient information into system.
- Provided excellent customer service to patients and medical staff.
- Answered incoming calls, scheduled appointments and filed medical records.
- Followed document protocols to safeguard confidentiality of patient records.
- Engaged with patients to provide critical information.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Resolved customer complaints using established follow-up procedures.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Organized patient records and database to facilitate information storage and retrieval.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
Insurance Verification Specialist
Aston Carter
09.2019 - 03.2021
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Demonstrated a high level of professionalism and attention to detail in all aspects of insurance verification specialist role, consistently exceeding performance expectations.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Developed strong relationships with insurance representatives, facilitating smooth communication channels for resolving inquiries or disputes.
- Expedited patient registration process by efficiently validating eligibility for various insurance plans.
- Reduced errors in billing by accurately maintaining patient records with updated insurance information.
- Optimized productivity within the department by prioritizing tasks according to urgency and importance levels.
- Coordinated with care teams across various departments to ensure seamless integration of verified coverage information into overall treatment planning.
- Implemented improvements to existing verification processes, increasing accuracy rates while reducing time spent on manual tasks.
- Generated reports to track insurance verifications and claim progress.
- Negotiated payment plans on behalf of clients facing financial hardship, helping them access necessary healthcare services without undue burden.
- Increased accuracy of insurance verification, ensuring compliance with both provider and insurer requirements.
- Ensured accuracy in patient insurance information by meticulously verifying details, leading to reduction in claim denials.
- Facilitated successful introduction of new electronic verification system, improving data accuracy.
- Optimized use of insurance verification software, leading to faster processing times.
- Maintained up-to-date knowledge of insurance policies and changes, aiding in accurate verification.
- Enhanced patient trust by ensuring personal and sensitive information was handled with confidentiality during verification process.
- Enhanced patient satisfaction by providing clear explanations of insurance benefits and coverage.
- Assisted in negotiating with insurance companies to secure better coverage options for patients.
- Enhanced communication between medical staff and insurance companies, leading to more efficient patient care coordination.
- Performed various administrative tasks by filing, copying and faxing documents.
Senior Claims Representative
Blue Cross & Blue Shield of SC
04.2015 - 09.2019
- Improved team productivity by providing ongoing training and support to junior claims representatives.
- Reduced backlog of pending claims by introducing an effective triage system based on priority levels.
- Analyzed complex claims data, identifying trends, and recommending improvements to reduce future risks.
- Collaborated with legal and medical professionals to gather necessary information for claim assessments.
- Enhanced customer satisfaction with timely and accurate resolution of claims disputes.
- Actively contributed to continuous improvement initiatives within the organization aimed at refining claims handling procedures and customer service standards.
- Assisted in the development of updated internal guidelines for handling specific types of claims cases.
- Managed a large caseload while maintaining strict deadlines and delivering consistent results under pressure situations.
- Conducted thorough investigations of disputed claims, gathering evidence to support decision-making processes.
- Expedited the approval process for genuine claims, maintaining a high level of trust among policyholders.
- Reduced claims processing time by implementing efficient workflow and prioritizing tasks.
- Updated field operations staff on status of open claims and current actions.
- Developed strong relationships with insurance providers, promoting effective communication for claim resolution.
- Mentored new hires on company policies and procedures, fostering a productive work environment within the team.
- Streamlined claims documentation process, ensuring completeness and accuracy for faster approvals.
- Implemented new software tools for tracking claims progress, improving overall efficiency in the department.
- Provided exceptional customer service when addressing inquiries from clients regarding their claim status or policy coverage details.
- Conducted investigations into complicated mid- and high-exposure claims.
- Participated in cross-functional teams to evaluate organizational processes related to claims management, resulting in systemic enhancements.
- Developed in-depth understanding of insurance policies and procedures.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained confidentiality of patient finances, records, and health statuses.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Modified, updated and processed existing policies.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Coordinated with contracting department to resolve payer issues.
Education
GED -
South Carolina Department Of Education
Columbia, SC11.2013
Skills
- Pre-authorizations
- Insurance verification
- Medical terminology
- Patient scheduling
- Multi-line phone proficiency
- Data entry proficiency
- Appointment scheduling
- Follow-up coordination
- Scheduling software
- Accurate documentation
- HIPAA regulations
- Database management
- Notetaking and documentation
- Record preparation
- Google suite proficiency
- Caseload management
- Organizational growth
- Healthcare systems
- Electronic patient charts
- Referral tracking
- Medical scheduling
- MS office expertise
- Outbound calls
- HIPAA guidelines
- Epic systems
- Utilization management
- Critical thinking
- Schedule management
- Electronic medical record software
- Process improvement
Timeline
Veteran Referral Coordinator
Virta Health
11.2024 - Current
Behavioral Health Scheduler
Tria Federal
11.2023 - 10.2024
Patient Access Representative
Ortho New York
03.2021 - 11.2023
Insurance Verification Specialist
Aston Carter
09.2019 - 03.2021
Senior Claims Representative
Blue Cross & Blue Shield of SC
04.2015 - 09.2019
GED -
South Carolina Department Of Education
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