Liliana J.

As a Senior Scheduler I am responsible for scheduling patients for Medical Nutrition and Diabetes Education services, throughout the Methodist Hospital, utilizing a computerized scheduling system and multiple software applications and interacting with all levels of staff and management, physicians, patients and families to obtain information and properly schedule services, using independent judgment and clinical knowledge to adjust schedules and accommodate special requests from patients. A Senior Scheduler is considered a leadership position requiring to work closely with management to meet the goals of the department.

As Insurance Verifier I am responsible for obtaining and recording eligibility and benefit information for patients receiving services at Houston Methodist Weight Loss and Bariatric surgery department. Benefits are obtained by using online resources such as: Epic estimate tool, RTE, Availity and change healthcare. The Insurance Verifier will utilize effective communication skills in all interactions with patients, co-workers, insurance companies, physicians.

Scheduling home health care for Brookdale Communities patients and outpatient care for the South West Region. Coordinate resident services and/or associate schedules. Responsible for filling all shifts. Ensure that community and corporate policies are disseminated and followed by all care associates. Complete data entry and administrative reporting as necessary. Coordinates alternative resources for associates and families.

Provide professional office administration and management support to all office activities. Establish and manage communication with corporate, market administration, clients, staff and management. Recruit, train and induct new staff for organization. Manage and monitor office functionaries such as personnel files, labor, accruals, payroll, accounts payable, processing of employee benefits and new employees. Prepare detailed reports on labor, attendance, and payroll. Coordinate with the Administrator and evaluate all office operations and provide support to create or modify procedures and policies. Organize and prioritize office tasks to fulfill all administrative requirements. Manage financial data files and compile monthly, weekly and daily reports. Maintain all office communication and human resources activities. Organize orientation programs for new staff. Collaborate with vendors and suppliers of office equipment to ensure compliance with company policies and procedures. Maintain all office equipment, files and records for effective functioning of office

Translate patient information into alphanumeric medical code. Collect, post, and manage patient account payments. Submit claims to insurance. Prepare and review patient statements. Review delinquent accounts and call for collection purposes. Process payments from insurance companies. Maintain strict confidentiality. Code patient services and enter into the computer. Ensure health care facilities are reimbursed for all procedures. Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding. Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.Use computers to read and organize charts. Follow up to see if a claim is accepted or denied. Investigate the rejected claim to see why denial was issued.

Responsibilities include; collect co-pay and other payments; post various charges; review modifiers for accuracy; schedule follow-up appointments; assist with billing/insurance duties and questions; reconcile credit card machine and money bag; faxing, scanning and additional duties as assigned.

Interview patients at workstations or bed-side registration performed utilizing carts/computers on wheels to ensure charts are completed and accurate. Verify all insurance and obtain precertification/authorization to calculate and collect patient liable amounts. Obtained all necessary signatures for treatments. Answer any questions and explain policies clearly. Process patient charts according to paperwork flow needs and established productivity standards.

Communicate with customers, employees, and other individuals to answer questions, explain information, take orders and address complaints. Answer telephones, direct calls and take messages. Compile, copy, sort, and file records of patients and office activities. Complete contracts, policies, and keep updated employees' files. Operate office machines, such as photocopiers and scanners, facsimile machines, voice mail systems and personal computers. Compute, record, and complete data and other information, such as records or reports. Maintain and update filing.

Home Support Scheduler at Eagle's Trace retirement community with over 450 residents. I supervised over 60 C.N.A. daily to provide 24-hour care for our clientele. (Independent living as well as patients with dementia, Alzheimer's and mental health issues) I am proficient in using Care Med-X Software. I was responsible for inputting new admits; updating the policy and procedure manual for company (corporate) and state policies. I input all data entry of all charges and scheduled employees to provide care for our patients according to their needs. I also verified and input payroll for the company, as well as answering billing questions. I worked closely in an interdisciplinary team environment working with but not limited to the Director of Nursing, Director of resident Life, Social Worker, Geriatric Physician, Physical Therapists and other health team members. I attended medical review weekly meetings. I coordinated all DME supplies, home health and physical therapy as Rx by physicians. Faxing, typing, maintaining medical records, filing and communication were all part of my daily job. I also helped to instruct C.N.A.s with mandatory training every month. I maintained personnel files on all employees.