Deborah Smith
McDonough
Summary
Experienced Insurance Verification Specialist with strong attention to detail and a commitment to patient confidentiality. Skilled in navigating insurance authorization processes, dedicated to improving accuracy in claims processing and enhancing customer service to support healthcare operations. Experienced with Epic system.
Overview
32
32
years of professional experience
Work History
Insurance Verification Specialist
Prime Healthcare Southern Regional
Riverdale, GA
03.2002 - Current
- Verifies patient insurance eligibility and benefits, ensuring accuracy in data processing.
- Coordinates with healthcare providers to obtain necessary documentation for claims processing.
- Implements streamlined workflows to enhance efficiency in insurance verification processes.
- Preregisters outpatient accounts to ensure procedures are approved and patients are aware of their financial responsibilities.
- Initiates Authorizations for Inpatient and Observation ER Admissions to ensure approvals for services.
Medical Biller
Visiting Nurse Health System
Norcross, GA
08.1998 - 12.2001
- Processed and submitted medical claims to ensure timely reimbursement from insurance providers.
- Acquired knowledge of Durable Medical Equipment and rental process.
- Audited Certified Medical Necessity forms to keep approval dates current.
- Reviewed Aging and Pending reports to assure timely billing.
Medical Biller
Grady Health System
Atlanta, GA
03.1994 - 08.1998
- Resolved billing discrepancies by collaborating with healthcare teams and insurance companies.
- Edited and Billed Commercial and Medicaid claims.
- Reviewed charges and added late charges to assure all services were properly billed.
- Performed Customer Service duties
Education
Certified Healthcare Access Associate
Hometown Health University
Cumming, GASkills
- Attention to detail
- Patient confidentiality
- HIPAA compliance
- Insurance coverage verification
- Insurance Authorization process
- Customer Service
- Epic training
Timeline
Insurance Verification Specialist
Prime Healthcare Southern Regional
03.2002 - Current
Medical Biller
Visiting Nurse Health System
08.1998 - 12.2001
Medical Biller
Grady Health System
03.1994 - 08.1998
Certified Healthcare Access Associate
Hometown Health University