Courtney Keys
Alexandria
Summary
Reliable professional offering an extensive career, promoting positive customer experiences. Demonstrates strong skills in administrative work, documentation management, and fostering effective communication between patients, providers, and insurance companies. Known for problem-solving capabilities, precision in task completion and ability to positively impact workflow efficiency.
Overview
8
8
years of professional experience
Work History
Financial Clearance Specialist
Addison Group/ Boston Children's Hospital
Remote
12.2023 - 10.2024
- Obtaining all authorizations and physician referrals in accordance with insurance companies' medical and administrative policies.
- Managing daily high-volume caseloads to ensure timely completion of financial clearance in accordance with departmental processes and payer guidelines.
- Communicating authorization statuses with key stakeholders (physicians, nurses, and management) throughout the authorization process.
- Supporting physicians and other clinicians in payer denial processes.
- Collaborating with clinical departments, case managers, and clinical liaisons to ensure payer authorizations.
- Reviewing and analyzing payer denials to determine opportunities for reimbursement.
- Facilitating peer-to-peer reviews when needed to secure authorizations.
- Documenting all actions taken on accounts with clear and concise account notes.
- Participating in process improvement activities.
Customer Service Representative
Bpci/ United Health Care
Remote
01.2021 - 01.2023
- Demonstrate understanding of internal/external factors that may drive caller questions/issues (e.g., recent plan changes, mass mailings, call directing/rerouting, weather emergencies)
- Ask appropriate questions and listen actively to identify underlying questions/issues (e.g., root cause analysis)
- Gather appropriate data and information, and perform an initial investigation to determine the scope and depth of the question or issue.
- Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed.
- Proactively contact external resources as needed to address caller questions/issues (e.g., providers, labs, brokers).
- Utilize appropriate knowledge resources to drive the resolution of applicable questions/issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint).
- Identify and communicate steps and solutions to caller questions and issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds and descriptions of relevant processes).
- Offer additional options to provide solutions and positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, and workarounds for prescription delays).
- Make outbound calls to resolve caller questions/issues (e.g., to callers, providers, brokers, and pharmacies).
- Drive resolution of caller questions/issues on the first call whenever possible (e.g., first-call resolution, one-and-done).
- Ensure proper documentation of caller questions/issues (e.g., research conducted, steps required, final resolution).
Financial Clearance Specialist
Medstar Washinton Hospital Center
Washington
01.2017 - 12.2020
- Contributes to the achievement of established department goals and objectives, and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
- Provide excellent customer service in all patient communication, with the goal of providing accurate and timely registration and scheduling, educating, and providing service and support as the first point of contact for MedStar Washington Hospital Center Hospital.
- Timely and accurately verify and schedule patients, following all policies and procedures, including patient identifiers and patient confidentiality.
- Verifies eligibility and benefits, and obtains authorizations when needed for all services specific to the clinical department and location.
- Performs the duties of a registrar as needed, and maintains an error rate of less than 2%. Review registrations for accuracy, completeness, and perform any necessary corrections in a timely manner.
- Maintains a professional relationship with other departments within the facility, including assisting and working with, and as part of, the Revenue Cycle Team.
- Obtains authorizations to ensure maximum reimbursement, to meet patient satisfaction, to maintain all payer rules and regulations, and to ensure corporate compliance.
- Timely and accurate completion of work lists and work queues, and maintaining records to ensure that all required data elements and information are validated.
- Demonstrate ongoing knowledge and competency of the scheduling and registration systems, including applications, and other assigned system tools.
Education
Some College (No Degree) - Nursing
Technical Learning Center
WashingtonSkills
- Document verification
- Record management
- Financial records and reporting
- Data entry and management
- Communication
- Medical office procedures
- Insurance information oversight
- ICD-10 coding
- Medical coding
References
References available upon request.
Timeline
Financial Clearance Specialist
Addison Group/ Boston Children's Hospital
12.2023 - 10.2024
Customer Service Representative
Bpci/ United Health Care
01.2021 - 01.2023
Financial Clearance Specialist
Medstar Washinton Hospital Center
01.2017 - 12.2020
Some College (No Degree) - Nursing
Technical Learning Center
Similar Profiles
Emme MartinEmme Martin
Patient Experience Representative at Boston Children's HospitalPatient Experience Representative at Boston Children's Hospital
David DumaisDavid Dumais
Operations Manager at Boston Children's HospitalOperations Manager at Boston Children's Hospital
Amanda Chaudhary, BSN, RNAmanda Chaudhary, BSN, RN
Pediatric Hematology/OncologyHSCT Nurse at Boston Children's Hospital, 6NPediatric Hematology/OncologyHSCT Nurse at Boston Children's Hospital, 6N