Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

SHANTA LOCK

Maricopa

Summary

Proactive Patient Access Representative with a proven track record at Dignity Health, excelling in patient registration and insurance verification. Proficient in EPIC and Cerner systems, I enhance patient experiences through clear communication and collaborative teamwork, ensuring seamless intake processes, and accurate billing. Committed to delivering exceptional service in any healthcare environment.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Patient Access Representative

Dignity Health
09.2021 - Current
  • Serve as the first point of contact for patients and vendors entering the Emergency Room, ensuring a welcoming and efficient intake process.
  • Accurately collect and update patient demographics, and insurance information to ensure proper billing.
  • Handle and direct incoming calls to appropriate clinical and support staff, including physicians, nurses, and radiologists.
  • Verify insurance coverage, and obtain necessary authorizations for billing accuracy.
  • Collect co-pays and other required payments for emergency services.
  • Ensure the completion of all required consent forms and documentation before and after patient visits.
  • Scanned documents into electronic medical records system.

Patient Service Representative

Advocate Aurora Healthcare
10.2018 - 09.2021
  • First point of contact for patients and visitors in the primary care and urgent care settings.
  • Greet and register patients while assisting them in completing all required forms and documentation for their visit.
  • Obtains demographic and insurance information.
  • Collects co-payment and posts payments, if required, during the visit.
  • Schedules new and follow-up patient appointments. Handles all no-shows, patient dismissals, and/or appeals.
  • Organizes various community events throughout the clinic and urgent care spaces.

Insurance Authorization Representative

10.2017 - 10.2018
  • Ensure all patient information is complete and accurate, applying knowledge of Medicare, Medicaid, and third-party payer requirements, using online eligibility systems.
  • Contact insurance carriers to verify policy limitations, benefit coverage, and obtain prior authorizations, as needed.
  • Collaborate with internal departments to provide account status updates, resolve billing or authorization issues, and appeal denied claims or authorizations.

Statistical Clerk

10.2014 - 10.2017
  • Evaluate statistical claims and premium data for accuracy and compliance.
  • Prepare automated filings for the National Council on Compensation Insurance (NCCI).
  • Review policy coding documents from underwriting for accuracy and completeness.
  • Calculate standard premiums for Workers’ Compensation, and report audit exposures to NCCI and independent bureaus.
  • Process premium and exposure data for General Liability and Auto policies.
  • Compare, calculate, and enter claim data into internal systems.
  • Balance the monthly paid-to-date and outstanding reserve totals.
  • Perform balancing procedures for premium and claims processing, and investigate and resolve discrepancies.

Education

BACHELOR OF SCIENCE - HUMAN SERVICES

Springfield College
Milwaukee, WI
01.2011

Skills

  • Administrative skills
  • EPIC and Cerner proficiency
  • Medical scheduling
  • Team collaboration
  • Health insurance proficiency
  • Referral specialist
  • Risk management
  • CPT and ICD coding
  • Patient registration
  • Payment collection
  • Communication skills

Certification

  • BLS Certified (American Heart Association), Current

Timeline

Patient Access Representative

Dignity Health
09.2021 - Current

Patient Service Representative

Advocate Aurora Healthcare
10.2018 - 09.2021

Insurance Authorization Representative

10.2017 - 10.2018

Statistical Clerk

10.2014 - 10.2017

BACHELOR OF SCIENCE - HUMAN SERVICES

Springfield College
SHANTA LOCK