Quintavious Stephens

Serving meals and assisting with feeding. Providing oral hygiene and personal care. Assisting with positioning and repositioning patients. Answering patient calls and determining how best to help them. Updating electronic health records and charts. Cleaning rooms and bed linens. Stocking supplies.

Manage and Create Team meetings. Discuss future goals with Team. Reporting findings to the development team. Handling Copay Issues. Getting Prior Authorizations via payors. Outlining and driving improvements. Tracking progress on issue resolutions. Processing of Medicare enrollments, disenrollments, cancellations, social manual application and other data entry as required. Applies CMS rules and reviews CMS system(s) to make eligibility determinations. Using FACET to process claims.

Works with the Engagement Center and Patient Service Representatives to verify proper insurance coverage. Using Saleforce, SAP and ERP software tools. Makes calls TO patients daily to facilitate collectability and resolve insurance issues. Takes patient calls regarding billing questions and resolves disputes. Submit past-due unresponsive patient balances to the collection agency. Review the explanation of benefits (EOB) for patterns of rejected claims, then scan paper records into EMR. Create, assign, and close work request tickets using ServiceNow Ticketing Software. Using FACET to process claim. Achieved an 80% call resolution rate. Work with outside billing agencies to resolve billing issues. Help desk ticketing system (Service Now) for working tickets and managing priorities. Record patient payments into EMR. On Call Collaborated with medical staff and other departments to coordinate patient care and services.

Provide client engagement and support activities for Medicare beneficiaries. Assist with new client onboarding: Evidence of coverage verification, clarify any plan questions and assist with in-network provider assignment. Answer Incoming phone calls and engage in outbound call campaigns as assigned. Take initiative to resolve client inquires, concerns, and work to provide real time resolution. Take on customer support assignments and projects. Address customer inquiries and needs which may be related to plan benefits and coverage. Worked with end-users on understanding technical issues via phone and documented in ServiceNow. Provided general help desk duties during regular business hours and on call after hours support. Assist customers with benefit utilization, which may include registration for carrier’s member portal, mail-order pharmacy enrollment, and over-the counter benefits.

Using Salesfore, SAP to assist patient account payables and billing payables. Accurately obtains all patient demographic, insurance, and HIPAA information. Verifies and scans Insurance, IDs, updated Demographics, Addresses, Emails, and other patient information. Monitors arrival of patients and communicates any cancellations, delays, or other problems to the facility Management Team as they arise. Collects co-pay, deductible, and outstanding balance payments from patients and posts same. Utilized ServiceNow as primary ticketing system, routed trouble tickets to respective departments, resolved when needed, escalated when necessary or requested. Issues receipts accordingly. Notifies patients of any changes in arrive time should surgery/appointment times change due to delays, cancellations, etc. Answers telephone and directs calls to appropriate area within the facility. Assists in scanning all documentation into various computer systems to maintain accurate files. FMLA. Using FACET to process claims. Worker's Comp.

Provide billing, collections and claims for Banner Health Hospital. With compliance to HIPPA. Provide customer service to health plan members and patients. Answer inbound calls for health care customer service. Provide customers with benefits, legibility, physician coverage and Enrollment verifying eligibility of insurance and other forms of reimbursement along with collecting money due at the point of service. Quickly input date and navigate systems while assisting members. Active listening, service oriented and multi-tasking. Active Directory account creation and permissions (Windows Server 08, 12), Office 365 Admin, Imaging (Altiris, Ghost), Ticket Management (Heat), EMR experience. Attend staff meetings.