Candace Resume
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Candace Resume

Candace M. Green (Simon)
Dallas, Texas
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CAREER OBJECTIVE
I have received favorable reviews in my current position that note I am reliable, responsible, and detail-oriented. I am now seeking a challenging position in which experience, skills, education, and training may be utilized to achieve organizational and personal goals and objectives.

EDUCATION
Northwood University, Cedar Hill, TX
Bachelors of Business Administration in Management, 2010

SUMMARY OF QUALIFICATIONS
Self-directed, highly creative team player with strong organizational and analytical abilities
Interfaces effectively with personnel at all levels of an organization with discretion
Possesses exceptional interpersonal, written, and verbal communication skills
Able to focus on both the micro and macro views, while executing with meticulous detail

EXPERIENCE
UT SOUTHWESTERN MEDICAL CENTER – TRADITIONAL AND INTERVENTIONAL RADIOLOGY INSURANCE VERIFICATION
Insurance Verification Team, June 2018 – July 2019

Verify and pre-authorize all applicable scheduled imaging services prior to patient’s arrival for Radiology, Diagnostic Lab / X-ray, and Nuclear Medicine visits for patients in the CRS work queue.
Work by my assigned alpha pre-fix all cases assigned to me and clear from the work queue on a daily basis no less than 5 days prior to the date of service.
Obtained authorization via several websites including AIM, EVICORE, HEATH HELP, and UNITED HEALTHCARE etc.…
Used my access to several websites to verify coverage for patients including ONESOURCE, AVAILITY, TRI-WEST, UNITED HEALTHCARE, and CIGNA, etc.…
Status the DAR for front desk check-in / check-out staff for all patients.
Answer all incoming calls on the ACD line.
Answer all incoming emails from other departments for add-on patients or patients presenting new/different insurance at the time of service.
Call patients to advice of any co-pay amounts. Also created/quoted any and all self-pay estimates.


UT SOUTHWESTERN MEDICAL CENTER – CENTRAL REGISTRATION
Central Registration Specialist, May 2016 – June 2018
Reviews, verifies, and obtains demographic, guarantor, subscriber, and payer information to successfully complete benefits verification, authorization, and precertification processes.
Coordinate with patient, referring location, scheduled service area, financial counselors, and others as appropriate to obtain additional information or provide an update on patient's financial status.
Counsels offices and/or patients when an out of network situation becomes apparent or other potential payer technicalities arise.
Coordinates with Financial Counselor, clinic, patient or other appropriate party to identify funding source and additional information needed to secure accurate third party billing and/or patient financial responsibility.
Provides financial planning and counseling to patients and families in order to obtain payment for services rendered in accordance with policies and guidelines.
Works closely with various agencies and departments throughout the health system to ensure correct billing as well as effective patient account resolution.
UT SOUTHWESTERN MEDICAL CENTER – DEPT. OF OTOLARYNGOLOGY
Surgery Precertification/Preceptor, January 2012 – May 2016
Call insurance companies to obtain benefits information in order to pre-certify all in/outpatient surgeries
Scan all authorizations into the computer under individual patient accounts
Set up all peer-to-peer discussions with medical directors and doctors to get costly cases approved
Assist supervisor with creating ClearQuote estimates for patients to pay deductibles, copays, and out of pocket fees prior to surgery
Attend CEU classes to keep up with changes in system functions, healthcare policies, and government programs for Medicare / Medicaid patients
Support supervisor by training new employees
Assist trainees in getting acclimated to clinic culture and policies
Coordinate continuing education courses for all employees throughout the clinic

Ancillary/CSA Scheduler, November 2007 - January 2012
Called to schedule patients procedures such as MRI/MRA, CT and PET scans, FNA
(fine-needle aspirations), Sono Thyroid Biopsy, Ultra Sound Guided Needle Biopsy, and Nuclear Medicine
Coordinated appointments with follow-ups for physicians, Audiologist, and Physical Therapist within the clinic
Scheduled Vestibular Diagnostic Tests, Hearing Aid Evaluations, Audio Exams, and Physical Therapy
Preauthorized all tests with multiple insurance companies, via online or telephone.
Maintained information for multiple doctors regarding patients’ orders for scans and tests


UNITED HEALTHCARE/STUDENT RESOURCES
Claims Examiner, January 2007 – September 2007
Examined student insurance health claims for the nation’s highest volume carrier
Utilized knowledge of individual blanket policies, calculations of covered and non-covered services, and vast PPO exposure
Maintained information for assigned schools via problem solving and consistent application of compliance with multi-state laws concerning health insurance and completed HIPAA training.

Customer Service Representative, March 2004 – January 2007
Handled 60-80 incoming calls per day from students, healthcare providers, other insurance companies, collection agencies, and attorneys inquiring on claims for illness and injury insurance policies for college students and K-12
Processed paperwork for claims that are mailed or faxed for medical claims to be paid or adjusted


BARRETT, BURKE, WILSON, ET AL, LLP
Eviction Assistant, August 1999 - November 2003
Prepared “notice to vacate” letters to debtors
Requested documents from title companies
Maintained information used to updates clients on their loan status
Referred information packets with all appropriate documents to outside counsel
Arranged all court dates with Justices of the Peace for all 254 counties in the State of Texas both for jury and non-jury trials
Handled incoming customer service calls from debtors, clients, opposing attorneys, and law enforcement
Maintained files to ensure they were billed on time and mailed to clients

Customer Service Representative, July 1998 – August 1999
Handled 80-120 incoming calls from debtors trying to reinstate, payoff, or get a loan modification prior to foreclosure
Assisted attorneys with pending foreclosure cases