Kandy Anderson
Homewood
Summary
Results-driven professional with over 20 years of experience in member and customer service, excelling in roles that require reliability and attention to detail. Proficient in Microsoft Products, EPIC, and Oracle, with a strong background in claims adjudication for Blue Cross Blue Shield and Aetna/AARP. Recognized for leadership abilities and mentoring skills, consistently exceeding departmental goals through effective implementation of procedures and compliance with HIPAA regulations. Proven track record of delivering high-quality results in fast-paced environments, with strong verbal and interpersonal communication skills.
Overview
5
5
years of professional experience
Work History
Patient Service Representative/Customer Service
Advocate Medical Group
Orland Pk.
2024.02 - Current
- Streamline patient registration processes through patient check-in, schedule scrubbing, and validation of confidential health and financial data.
- Executed administrative support tasks including preparation of correspondence and forms.
Managed confidential reports with strict adherence to privacy protocols. - Swiftly managing incoming calls, resolving patient and staff inquiries or escalating as necessary.
- Coaching and supporting new hires through hands-on training.
- Supporting management in peer-to-peer interviews for prospective candidates.
- Possess extensive knowledge of medical terminology, encompassing DX, CPT, and ICD-9 coding.
- Delivered exceptional customer and patient service by acknowledging patient concerns and requests while adhering to insurance and office protocols.
- Work queue coordination for specialties encompassing Physical/Occupational/Speech Therapy, Pain Management, Gastroenterology, etc.
- Accurately verified patient insurance eligibility and updated records accordingly. Executed a comprehensive analysis of co-payments, deductibles, and out-of-pocket costs. Explaining differences between in-network and out-of-network insurances to patients. Ensured precise documentation and processing of verification activities.
- Elucidating registration and admission forms to patients and guarantors, prior to obtaining signatures.
- Execute administrative tasks encompassing typing, form completion, photocopying, sorting mail, and scanning daily correspondence such as vaccine records, HIPAA forms, adolescent consents, etc.
- Provided exceptional customer service to patients and families in a fast-paced environment.
Patient Financial/Billing and Benefit Services
Rush Copley Medical Center
Aurora
2021.03 - 2024.02
- High-volume inbound call center managing patient billing inquiries, concerns, complaints, etc.
- Facilitate patient assistance and counseling for outstanding balances, including payment plan options, SBO/Self-pay Discounts, and Charity/Financial Assistance programs.
- Delivered comprehensive education to patients regarding claim processing and benefits.
Explained deductibles, co-insurance, and collection accounts to enhance patient understanding.
Advised on IDPA/Medicaid eligibility and government agency resources, including VA and Medicare.
Outlined various commercial insurance options for informed patient decision-making. - Patient assistance encompassing medical conditions, diagnosis, insurance terminology, pharmaceuticals (RX), insurance benefits, contractual language, standard preventative treatments, medical procedures, etc.
- Coached and guided new hires as an On-The-Job Trainer
- Supporting management with execution of peer-to-peer interviews for potential candidates.
- Displayed strong understanding and experience in medical terminology, incorporating DX/CPT/ICD-9 coding.
- Facilitate de-escalation and resolution of challenging calls consistently without supervisor assistance.
- Third Party Liability (TPL) accounts, including work-related injuries, motor vehicle accidents, etc.
- Designated special projects.
- Analyzing daily correspondence encompassing HIPAA/Authorization, Death Certificates, Insurance Documents (EOB/Explanation of Benefits), Refunds/Audits, Bankruptcy, etc.
Education
General Studies
Triton College
River Grove, IL1998-03
Skills
- Patient registration
- Medical terminology
- Insurance verification
- Claim processing
- Administrative support
- Customer service
- Benefits verification
- Problem solving
- Effective communication
- Conflict resolution
- Detail orientation
- Accuracy and precision
- Training new hires
- Policy interpretation
- Benefits explanation
- Written and oral communication
- Highly skilled in Epic, Microsoft Office (Excel, Word, Outlook, Teams, etc), Oracle, Blue Chip, and Life Suite
References
Available upon request
Timeline
Patient Service Representative/Customer Service
Advocate Medical Group
2024.02 - Current
Patient Financial/Billing and Benefit Services
Rush Copley Medical Center
2021.03 - 2024.02
General Studies
Triton College