Jennifer Redgate
Pekin
Summary
Healthcare professional with extensive experience in patient navigation and support. Proven track record of accurate surgery scheduling and coordination of care. Highly reliable team player with strong focus on collaboration and adaptability, skilled in empathetic communication and resource coordination.
Overview
13
13
years of professional experience
Work History
Specialty Service Patient Navigator
OSF Illinois Neurological Institute
08.2021 - Current
- Coordinated with nurses and providers to enhance patient care and satisfaction during the surgery scheduling process and delivered support to nurses and providers in completion of patient paperwork or authorizations and denials.
- Improved surgery scheduling by managing OR schedule and nurse and provider requests. Responsible for scheduling, rescheduling and moving surgery times while consulting with nursing staff and providers to eliminate conflicts, to identify problems and potential denials and reschedules for neurosurgery team.
- Communicated with neurosurgery residents and hospital staff to schedule emergent inpatient surgeries.
- Coordinated OR schedule with charge nurse and scheduling staff to make sure the OR schedule accommodates all scheduled surgeries and emergent inpatient surgeries.
- Fostered strong relationships with device reps to expand available resources for patient surgeries.
- Answered incoming insurance and patient calls, and filed appeals for authorizations with medical records while maintaining accurate scheduling documentation.
- Supported patients in navigating insurance queries between our financial clearance department and insurance, improving financial clarity so our patients understand the authorization process and financial responsibilty.
- Educated patients on insurance and healthcare plans when needed and addressed patient concerns about the authorization process promptly, to increase trust in healthcare process and enhanced patient experience with personalized assistance and care coordination while ensuring patient understanding of the surgery plans with clear, compassionate communication.
- Conducted patient surgery arrival calls to ensure patient on-time arrival for next day surgery.
- Greeted and assisted patients with check-in procedures and gathered identification and insurance information, processed payments using cash and credit cards, maintaining accurate records of transactions while filling in for check in desk.
- Trained new employees on effective surgery scheduling techniques, ensuring continuity of care across the organization while providing excellent customer service.
- Trained new employees on scheduling neurosurgery orders, coordinating device reps, phone etiquette with patients and insurance, and other office duties.
- Created spreadsheets to document combo case surgeries with external surgeon offices.
- Participated in regular team meetings, huddles, staff meetings and to improve patient care. and helped develop strategies to improve overall efficiency in the scheduling process while maintaining high-quality care standards.
Specialty CSR II
Pekin Insurance
09.2018 - 11.2020
- Answered provider and member calls and provided claim details, payment information, claim status, and patient eligibility.
- Fax explanation of benefits to providers upon request.
- Listened to department voicemails and provide member and provider call backs and route voicemails to correct departments if needed.
- Data Entry – I log claims into claim system to be processed with a less than 2% error rate.
- Ran numerous reports for the department to provide information to department leads.
- Claim resolution. I worked a system called SDS where claims were routed to me after being submitted electronically but may have errors. I make sure that they are not a duplicate and actually Group Plan Solution claims and fixed any errors.
- Mail runs and check runs to make sure department mail is received and sent, and that incoming and outgoing checks are to accounting in a timely manner.
- Reviewed endorsements on cashed checks that we have paid to providers or members to make sure they were cleared by the appropriate party.
Patient Accounts Specialist RCCPII - Financial Ass
OSF Medical Group
01.2016 - 09.2018
- Processed financial assistance applications for patients needing assistance for their medical bills and working with those patients to get correct income documentation for their application to qualify them for the financial assistance program.
- Sent letters to patients requesting documentation needed to support the income they provided on their application or Federal Tax Returns.
- Calculated annual gross income and family size per Federal Poverty Guidelines.
- Worked several weekly financial reports that fall into specialized work ques and spreadsheets that require further investigation. This means I reviewed certain diagnosis and dates of service, to make sure we are able to write the balance off or if there is another responsible party such as an insurance to be billed like work comp insurance or third party liability. Then I make decisions on whether Financial Assistance should be applied and adjust those bills accordingly.
- Wrote off small and large medical bills as necessary while always using the OSF Mission “To serve our patients with the greatest care and love”.
- Sent and received faxes from patients and offices as needed.
- Worked monthly collections reports that had deceased patients listed. I had to investigate patients to see if there was a living spouse or estate and recall these from collections accordingly. After research I adjust the balances to NON-COMPLIAN FINANCIAL ASSISTANCE or UNCOLLECTABLE if there is no spouse or estate.
- I was also responsible for all previous responsibilities listed below. I was still responsible for overflow calls and training new employees as needed in my previous position as an associate.
Patient Accounts Associate RCCPI
OSF Medical Group
08.2012 - 01.2016
- Provided new employee training to new employees in our department.
- Took inbound calls and providing excellent customer service to patients in regards to patient billing questions, concerns, and billing and insurance issues.
- Obtained correct insurance information and used problem solving skills to help patients with billing concerns.
- Communicated with other departments for patients to provide or obtain detailed information that was requested or given to solve any billing issues.
- Made outbound calls to provide follow up for patients, made sure all issues are resolved in a timely manner.
- Worked incoming mail and written requests that patients sent in, resolving any issues and providing follow up if needed.
- Took credit card payments over the phone per patient requests.
- Contacted physician offices for patients and provided education regarding billing practices and patient concerns.
- Daily clerical work, data entry, worked returned mail and changed addresses, sent itemized bills upon request, returned after hour calls, etc.
Education
No Degree - Graphic Communications
Illinois Central College
East Peoria, ILSkills
- Patient education
- Healthcare system knowledge
- Crisis intervention
- Patient intake
- Data entry
- Problem-solving
- Healthcare communication
- Insurance navigation
- Organizational skills
- Critical thinking
- Registration and scheduling
- Detail-oriented
Timeline
Specialty Service Patient Navigator
OSF Illinois Neurological Institute
08.2021 - Current
Specialty CSR II
Pekin Insurance
09.2018 - 11.2020
Patient Accounts Specialist RCCPII - Financial Ass
OSF Medical Group
01.2016 - 09.2018
Patient Accounts Associate RCCPI
OSF Medical Group
08.2012 - 01.2016
No Degree - Graphic Communications
Illinois Central College