Gilbretta Edwards

Obtained prior authorizations for outpatient high-tech imaging procedures and sleep studies, ensuring compliance with HIPAA guidelines. Coordinated with insurance companies, provided clinical documentation, and managed communication with physicians regarding authorization denials and appeals.

Ensured the safety of Chicago Public School students during their commute. Assisted preschool-aged students in the classroom with various activities, including story time, meal time, reading, and literacy.

Verified and pre-certified patient insurance prior to service dates, utilizing internet research and direct communication with commercial insurance companies. Managed clinical documentation and prior authorizations, and collected deposits from patients with unmet deductibles or self-paying customers.

Verified patient insurance eligibility through Medicare's website and ensured proper documentation, including HIPAA and release forms, were filed correctly. Documented and notated patient information within the Medical Manager system.

Reviewed daily schedules to verify new patient insurance before visits and updated patient charts electronically for physicians. Recorded, scanned, and verified patient demographics for medical records, and flagged accounts using the Greenway program to ensure copay collection.

Addressed customer inquiries, complaints, and requests in a call center environment. Explained policies and fees to new customers and processed payments via check or credit card for new and delinquent accounts. Investigated and resolved payment discrepancies.

Assisted with sedation, surgery, and pre/post-operative patient care, also handling receptionist duties and insurance billing. Responsible for the sterilization of dental tools and setting up medical trays for procedures.

Completed a comprehensive program focusing on medical office administration and clinical procedures. Gained proficiency in assisting with patient care, medical billing, and administrative tasks.