Yasmeena Williams
Oxon Hill,MD
Summary
Detail-oriented subject matter expert with strong organizational skills. Ability to handle multiple projects simultaneously and work independently with a high degree of accuracy. Reliable individual bringing 10+ years of experience in healthcare environments. Maintains positive relationships with payors, patients,case managers and providers to provide full circle service.
Overview
8
8
years of professional experience
Work History
Patient Care Representative
Virginia Hospital Center Physician's Group
06.2023 - Current
- Maintained confidentiality of patient data and condition to safeguard health information.
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Responded to patient queries and concerns concerning insurance coverages and deductibles.
- Scheduled approximately 80 - 100 patients per day and made reminder calls.
- Answered incoming calls, scheduled appointments and coordinated with the appropriate departments to get the patient assistance in a timely manner.
- Resolved customer complaints using established follow-up procedures.
Payor Clearance Specialist
Children's National Medical Center
05.2022 - 05.2023
- Input all patient data regarding claims and prior authorizations into system accurately.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Verified eligibility and compliance with authorization requirements for service providers.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Prepared letters of medical necessity (LOMN), detailing reasons for denial and reasons services are imperative to the patient's health.
- Developed and maintained productive working relationships with healthcare providers.
- Communicated with people from various cultures and backgrounds on application process.
- Assisted clients with completion of applications and paperwork.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Interviewed applicants and explained scope of different available benefits.
- Tracked referral submission during facilitation of prior authorization issuance.
- Accomplished multiple tasks within established timeframes.
- Identified plans and resources required to meet project goals and objectives.
- Developed and initiated projects.
- Tracked project and team member performance closely to quickly intervene in mistakes or delays.
Patient Access Representative
Luminis Health (Anne Srundel Medical Center)
02.2021 - 04.2021
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Obtained temperatures of visitors and employees at entry of facility and asked screening questions.
- Followed CDC guidelines to establish accuracy and compliance with COVID-19 protocols.
- Documented all COVID-19 screenings, results and follow-up action on database to enable tracking history and maintain accurate records.
- Provided COVID-19 FAQs and educational material to patrons and employees.
- Supported office operations by expertly handling administrative needs.
- Answered patient inquiries and provided information about healthcare services.
- Coordinated with other healthcare professionals to provide patients with comprehensive care.
- Provided family members with general health education and tips for patient care.
- Scheduled patients for appointments and maintained master calendar.
- Helped clinical staff with in-office procedures by organizing spaces and passing instruments.
- Communicated changes in COVID-19 protocols to staff and visitors to provide real time information and enhance preparation.
Customer Service Representative
Artelye Marble & Granite
02.2020 - 02.2021
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Updated account information to maintain customer records.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Responded to customer requests for products, services, and company information.
- Utilized customer service software to manage interactions and track customer satisfaction.
- Helped customers locate products and checked store system for merchandise at other sites.
- Answered customer questions about sizing, accessories, and merchandise care.
- Maintained calm demeanor and professionally managed issues in busy, high-stress situations.
- Engaged with customers to effectively build rapport and lasting relationships.
- Engaged in friendly conversation with customer to better uncover individual needs.
- Generated new sales leads to achieve and exceed monthly sales goals.
Benefits Verification Specialist
AmerisourceBergen
10.2016 - 02.2020
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
- Checked employees' benefits enrollment for accuracy and inputted all data into [Software].
- Implemented open enrollment system to streamline benefits processes for employees.
- Analyzed and reported on employee benefits data to identify trends and develop strategies for improvement.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Contacted insurance companies to discuss and resolve unpaid claims and incorrectly paid claims.
- Used Epic to process benefit transactions.
- Developed relationships with providers and networks to achieve favorable client coverage.
- Educated clients on insurance policies and procedures.
Dispatcher
Mv Transportation Inc.
02.2016 - 09.2016
- Communicated with drivers and personnel to coordinate timely delivery of goods and materials.
- Managed conflict resolutions with customers, drivers and other personnel to encourage professional relationships and promote respect.
- Directed dispatching, routing, and tracking of [Number] fleet vehicles.
- Maintained professional relationship with shippers, receivers and drivers to increase trust, reliability and rapport.
- Closely monitored dispatch board to triage and prioritize over 100 daily calls.
- Provided information about routes, destinations and timelines to inform passengers.
- Received new orders, prepared documentation, and assigned personnel.
- Utilized customer feedback to improve customer service.
Senior Sales Representative
TSL Marketing
05.2015 - 02.2016
- Continually navigated issues and solved complex strategy problems affecting sales growth and business direction.
- Increased customer satisfaction ratings by successfully resolving challenges.
- Overcame various obstacles and closed sales on tough deals using strong negotiation and persuasion skills.
- Maintained routine communication with clients to assess overall satisfaction, resolve complaints, and promote new offerings.
- Directed sales support staff in administrative tasks to help sales reps close deals.
- Expanded new business and developed effective sales and marketing campaigns.
- Trained, coached, and mentored new sales associates for maximum performance.
- Answered customer questions about products and services, helped locate merchandise, and promoted key items.
- Kept detailed track of sales and customer information in company system.
Education
Associate of Applied Science -
Onondaga Community College
Syracuse, NYSkills
- Clinical Practice Operations
- Payment Arrangements and Negotiation
- Strategic Networking
- Time Management
- Benefits Explanations
- Medical Procedure Terminology
- Punctual and Hardworking
- Healthcare Operations
- Healthcare System Navigation
- Insurance Form Processing
- Process Improvement
- Project Management
- Administrative Supervision
- Multi-Line Telephone Systems
- Co-Payment Collection
- Case Management
- Attention to Detail
- Patient Chart Maintenance
- Patient Interviewing Skills
- Reliability and Dedication
- Reminder Calls
- Scheduling
- Documentation
- HCPCS Compliance
- Insurance Practices
- Organizational Skills
- Collection Management
- Insurance Coverage Verification
- Insurance Verification
- Google Workspace
- Good Telephone Etiquette
- PPE Compliance
- MS Office
- First Aid/CPR
- Data Entry
- Written Communication
- Cerner,Epic, Meditech Software Proficiency
- Reconciling Accounts
- Payment Method
- Medical Records Management
- Home Healthcare
- EMR Systems
Timeline
Patient Care Representative
Virginia Hospital Center Physician's Group
06.2023 - Current
Payor Clearance Specialist
Children's National Medical Center
05.2022 - 05.2023
Patient Access Representative
Luminis Health (Anne Srundel Medical Center)
02.2021 - 04.2021
Customer Service Representative
Artelye Marble & Granite
02.2020 - 02.2021
Benefits Verification Specialist
AmerisourceBergen
10.2016 - 02.2020
Dispatcher
Mv Transportation Inc.
02.2016 - 09.2016
Senior Sales Representative
TSL Marketing
05.2015 - 02.2016
Associate of Applied Science -
Onondaga Community College
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