Mireda Lewis
Clover
Summary
Adept at streamlining precertification processes and enhancing patient service efficiency, I significantly improved precertification accuracy at CEENTA. My expertise in insurance verification and strong communication skills facilitated successful appeals and reduced wait times, contributing to organizational growth. I excel in HIPAA compliance and medical billing, embodying professionalism and ethics in every task.
Overview
11
11
years of professional experience
Work History
Precertification Specialist Lead
CEENTA
10.2021 - Current
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Contributed extensively to departmental goals through consistent achievement of individual performance benchmarks related to precertification accuracy and timeliness.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Improved team productivity with regular training sessions on new software programs and tools utilized in the precertification process.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Expedited treatment commencement by promptly acquiring authorizations for medically necessary services within required timeframes.
- Analyzed trends in denials or authorization delays to identify opportunities for improvement within the precertification department.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Answered phone calls and messages for [Number]-physician [Type] medical facility, scheduling appointments, and handling patient inquiries.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Assisted with medical coding and billing tasks.
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Registered and verified patient records before triage with most up-to-date information.
Financial Counselor/Precertification Specialist
Piedmont Medical Center
01.2019 - 10.2021
- Identified healthcare resources and programs for patients unable to meet financial obligations.
- Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
- Assisted clients in reducing debt through customized repayment strategies and budget adjustments.
- Improved client financial stability by assessing their financial situations and developing tailored plans.
- Acted as an advocate for clients during creditor negotiations, working towards mutually beneficial agreements that facilitated debt resolution.
- Worked with clients to develop personal recommendations for improvement of financial circumstances, reducing debt and increasing income.
- Cultivated a positive, non-judgmental environment for clients to openly discuss their financial challenges and concerns.
- Monitored and updated financial plans to comply with client goals.
- Worked closely with insurance providers to assess suitable coverage options tailored to individual client requirements for risk management purposes.
- Greet and Answer phone calls and assist the patients when need.
- Inpatient auths on the patients as in IC-10 and procedure codes.
- Verifying insurances and making sure the estimates cost letters was correct before they got mailed out.
Tech Assistant/Receptionist
VMC
02.2015 - 03.2019
- Assisted with appointment scheduling for clients, improving overall office organization and time management.
- Contributed to overall team productivity by providing assistance on various ad-hoc projects as needed.
- Increased client retention by providing exceptional customer service during check-in and check-out processes.
- Enhanced customer satisfaction by efficiently managing incoming calls and directing them to appropriate departments.
- Managed multiple tasks simultaneously while maintaining professionalism under pressure during high-traffic periods at the front desk.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Handled cash transactions and maintained sales and payments records accurately.
- Kept reception area clean and neat to give visitors positive first impression.
- Resolved customer problems and complaints.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Sorted, received, and distributed mail correspondence between departments and personnel.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Paid attention to detail while completing assignments.
- Organized and detail-oriented with a strong work ethic.
- I assist the Vets and Techs with animals as in holding pets, medications, walking animals before surgeries and after.
- Cleaning kennels after each used or doing the stay.
Kennel Assistant/Pet Bather/Receptionist
Piper Glen Animal Hospital
07.2013 - 02.2015
- Minimized animal injury risk by monitoring behaviors and eliminating safety hazards.
- Monitored animal playgroups for aggressive behaviors in order to maintain safety of pet participants.
- Mixed and administered special food formulas to individual animals based on unique dietary needs.
- Monitored and maintained food and water of boarded animals according to animal dietary health guidelines.
- Kept animals clean and free of contaminants to promote optimal health.
- Kept cages, kennels, play yards, and grooming areas neat and clean.
- Ensured safety of all animals through proper handling techniques and adherence to established protocols.
- Collaborated with other staff members to create a positive work environment focused on delivering high-quality care to all animals in the facility.
- Assisted with grooming services such as bathing, brushing, nail trimming, and ear cleaning for improved pet hygiene and health.
- Provided post-operative care, collected specimens, cleaned instruments and filled prescriptions to assist veterinarians.
- Demonstrated strong multitasking abilities by managing multiple responsibilities simultaneously, including animal care, client interactions, and administrative duties.
- Provided compassionate care for sick or injured animals while they recovered under veterinary supervision at the facility.
- Completed daily cleaning of kennels, cages and public areas using disease control protocol to provide sterile environment.
- Monitored kennels for toy safety and removed choking hazards.
- Contributed to team efforts in emergency situations, assisting veterinarians with urgent medical procedures when necessary.
- Recorded information such as feeding schedules, appearance, behavior of boarded or hospitalized patients to monitor stay.
- Completed animal intakes to board animals, labeling all home items and toys properly.
- Monitored animal behavior for signs of illness or distress, promptly reporting any concerns to management or veterinary staff.
- Stocked kennel and cleaning supplies to maintain proper inventory for daily performance.
- Answer phones and greet clients as they walk in.
- Check clients in and out in timely manner.
Education
No Degree - Business Management
Miller-Motte Business College
Wilmington, NCHigh School Diploma -
James Kennan High School
Warsaw, NC05-1998
Skills
- Prior authorization
- Strong communication skills
- HIPAA compliance awareness
- Organizational growth
- Insurance verification expertise
- Professionalism and ethics
- Medical billing
- Medical coding
- Electronic health records management
- Effective communication skills
- Documentation and paperwork
- Verbal communication
- Microsoft office
- Data entry
- Telephone etiquette
Timeline
Precertification Specialist Lead
CEENTA
10.2021 - Current
Financial Counselor/Precertification Specialist
Piedmont Medical Center
01.2019 - 10.2021
Tech Assistant/Receptionist
VMC
02.2015 - 03.2019
Kennel Assistant/Pet Bather/Receptionist
Piper Glen Animal Hospital
07.2013 - 02.2015
No Degree - Business Management
Miller-Motte Business College
High School Diploma -
James Kennan High School
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