Courtney McClure
Petros
Summary
Dynamic Pre-Certification Specialist at Tennessee Orthopaedic Alliance with expertise in benefits administration and effective communication. Achieved timely insurance verifications, enhancing patient care efficiency. Proficient in Microsoft Office and adept at conflict resolution, ensuring seamless operations and superior service delivery in high-pressure environments.
Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Dedicated administrative professional with successful experience in fast-paced office settings. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision.
Overview
10
10
years of professional experience
Work History
Pre-Certification Specialist
Tennessee Orthopaedic Alliance
10.2024 - Current
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Generated reports to track insurance verifications and claim progress.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Delivered prompt service to prioritize customer needs.
- Increased efficiency and performance by monitoring team member productivity and providing feedback.
- Identified and resolved discrepancies and errors in customer accounts.
- Met customer call guidelines for service levels, handle time and productivity.
Patient Service Representative
Oak Ridge Gastroenterology
03.2019 - 10.2024
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Took copayments and compiled daily financial records.
- Assisted patients in filling out check-in and payment paperwork.
- Handled customer service inquiries in person, via telephone and through email.
- Entered patient demographic and insurance data into electronic medical record system.
- Verified insurance eligibility and coverage for patients.
- Maintained personnel records and updated internal databases to support document management.
- Educated staff on organizational mission and goals to help employees achieve success.
- Devised and implemented processes and procedures to streamline operations.
- Gathered, organized and input information into digital database.
- Increased office participation in special events by creating newsletter with detailed calendars and other office updates.
- Completed forms, reports, logs, and records to quickly handle all documentation for human resources.
- Assisted coworkers and staff members with special tasks on daily basis.
Administrative Assistant
Express Healthcare
03.2018 - 03.2019
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Maintained inventory of office supplies and placed orders.
- Established administrative work procedures to track staff's daily tasks.
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
- Organized logistics and materials for each meeting and took detailed notes for later dissemination to key stakeholders.
- Built and maintained excellent customer relationships through timely response to inquiries and going above and beyond to accommodate unusual requests.
- Created and maintained detailed administrative processes and procedures to drive efficiency and accuracy.
- Continually sought methods for improving daily operations, communications with clients, recordkeeping, and data entry for increased efficiency.
- Opened and properly distributed incoming mail to promote quicker response to client inquiries.
Medical Coder
TeamHealth
04.2015 - 11.2017
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Verified signatures and checked medical charts for accuracy and completion.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
- Maintained accuracy, completeness, and security for medical records and health information.
- Utilized electronic medical record systems to store, retrieve and process patient data.
Education
No Degree -
Roane State Community College
Harriman, TNHigh School Diploma -
Coalfield School
Coalfield05-2012
Skills
- Conflict resolution techniques
- Recordkeeping and data input
- Resource information
- Documentation and paperwork
- Effective communication skills
- Documentation and reporting
- Benefits administration
- Policy interpretation
- Knowledgeable in Microsoft
- Microsoft office
- Data entry
- Appointment scheduling
Timeline
Pre-Certification Specialist
Tennessee Orthopaedic Alliance
10.2024 - Current
Patient Service Representative
Oak Ridge Gastroenterology
03.2019 - 10.2024
Administrative Assistant
Express Healthcare
03.2018 - 03.2019
Medical Coder
TeamHealth
04.2015 - 11.2017
No Degree -
Roane State Community College
High School Diploma -
Coalfield School
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