University of Washington, Seattle

Bellevue College

Franklin High School

Clinical Review Coordinator at Kaiser Permanente

Skills: Teamwork · Attention to Detail · Communication

Kaiser Permanente

Clinical Review Coordinator

Review Services Coordinator

General Duties:
- Registered and checked-in patients in a timely manner
- Collected and verified patient demographic information, insurance eligibility, authorizations, and referrals
- Ensured each patient understood and signed any consent forms for a procedure, financial agreements, and privacy practice acknowledgements
- Maintained inventory of office and medical supplies on a weekly and monthly basis
- Used fax, copy, and scanner to complete daily tasks

Appointment Scheduling:
- Scheduled appointments consistent with the office guidelines and patient needs
- Triaged emergency appointments and emergency room visits as necessary

Telephone Support:
- Called patients on the recall list to schedule annual eye exams or follow-up appointments
- Managed multiple phone calls at a time
- Investigated both in-office and out-of-office complaints such as billing and working with the appropriate staff to find a solution

Referral Coordination:
- Ensured that each referral is linked with a patient's appointment
- Wrote letters to the referring doctors updating them with the patient's progress
- Coordinating patient care with other departments and referring patients to other clinics

Medical Record Activities:
- Reviewed schedule on a daily basis in preparation of the day
- Reviewed medical record requests and sent the necessary medical records in a timely manner
- Prepared, organized, and sorted all superbills, exam forms, and consent forms

Billing Activities:
- Prepared all demographics, insurance, and superbills for billing
- Collected and processed patient payments using online system

Clinical Experience:
- Obtained patient's medical history, current medications, allergies, and reason(s) for visit
- Performed patient pretests (auto refractor, visual field testing, visual acuity, motility, confrontational visual field testing, etc.)
- Phoned-in or faxed in patient prescriptions
- Inserted dilated eye drops and touching the sclera using fluorescein strips

The Eye Institute

Front Desk/Administrative Assistant

General Duties:
- Assists in orienting new staff with policies and procedures
- Reviews email account on a daily basis and ensure each email is responded to within 24 hours
- Maintains cleanliness of office space
- Organizes, files, and labels both medical and non-medical documents such as patient demographics, insurance information, claims, Explanation of Benefits (EOBs), etc.
- Creates marketing materials to attract more clients looking to outsource their medical billing
- Maintains inventory of office supplies and makes supply orders
- Verifies, prepares, and sends out patient statements

Telephone Support:
- Answers the all telephone calls in a professional, courteous, and efficient manner
- Gathers the necessary information to address patient needs and concerns in a single phone call
- Communicates basic information to patients such as insurance benefits, co-pays, reason for insurance denials, deductibles, etc.
- Inform the patient of each clinic's guidelines on how payments are received
- Prioritizes and responds to patient inquiries respectively (phone, email, and mail)

Billing Activities:
- Processes and posts patient co-pays, coinsurance payments, and insurance Explanation of Benefits (EOBs)
- Submits medical claims for various specialities
- Follows up on claims that have not been paid in 30 days by calling provider services or checking claims status online
- Appeal claims that have been denied for various reasons such as timely filing, lack of medical records, not medically necessary, etc. to assure the client we have done everything we can do to get the claim paid 
- Knowledge in ICD-9, ICD-10, and CPT Codes

Jessica Gabuyo