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, WI01.2011
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