SHEREH FRANCIS
Bridgewater
Summary
Knowledgeable Patient Administrative Coordinator offers demonstrated skills in service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards. Possess specialized skills in patient scheduling, medical billing, and healthcare team communication. Excel in time management, ensuring smooth coordination of medical services and support to both staff and patients.
Overview
25
25
years of professional experience
Work History
Patient Administrative Coordinator
Boston Children's Hospital
08.2023 - Current
- Manages the prior authorization process for patients and/or may train on more complex prior authorization processes in support of specialized medical devices.
- Serve as point of contact on the process for obtaining and responding to additional requests for prior authorizations for medicines/medical devices across relevant insurance companies for supported clinical area.
- Accurately creates and compiles bills and invoices (private insurance, Masshealth, and self-pay) with correct billing CPT code, diagnoses code, provider, etc. and submit to billing department daily.
- Answers phone and email inquiries from patients and families and external companies in coordination of clinical services. Records and forwards messages as needed.
- Conduct comprehensive assessments to identify an individual's clinical and psychosocial needs, choices, and preferences for services.
- Assess and address health and safety issues as well as barriers to care and treatment including social determinants of health.
- Develop and maintain a person-centered Life Plan that coordinates and integrates an individual's clinical and non-clinical healthcare related needs and services.
- Monitor and facilitate implementation of and provide updates as needed to the Life Plan.
- Incorporate health promotion and support opportunities for individuals to achieve and maintain optimal health and wellbeing.
- Coordinate and ensure access to chronic disease management.
- Facilitate referrals to clinical and community resources, including planning, referrals, and follow-up for transitional care.
- Coordinate and provide access to long-term care supports and services.
- Engage families and natural supports into the care coordination process.
Administrative Coordinator/ Surgical Scheduler
Boston Medical Center
07.2022 - 08.2023
- Responsible for all aspects of office operations including preparation of spreadsheets, charts.
- Scheduling meetings, managing calendars, taking minutes of meetings.
- Maintaining office inventory, ordering supplies.
- Sorting & distributing mail, responding to inquiries, triaging and routing calls.
- Processing personnel action forms, collecting and submitting timesheets.
- Maintaining all departmental and employee files and records, assisting with new hire set-up.
- Maintaining departmental website content up-to-date.
- Schedules surgeries and related appointments.
- Communicates with all providers and patients.
- Completes all necessary related paperwork and documents, FMLA forms, prior authorizations and more.
- Responsible for all administrative duties related to scheduling gynecology procedures in OBGYN.
- Communicate regularly with the Director with questions re: schedules, projects, trainings, or other administrative challenges.
- Maintain administrative and clerical stock and supply including consents, patient handouts, and educational materials.
- Deals discreetly with highly sensitive, confidential written, electronic, and oral communications concerning staff, department, and hospital matters.
- Exercises discretion and independent judgment with respect to matters of significance to the department and the institution.
- Tracks all data, correspondence, committee and administrative operations related to the department and associated committees.
Administrative Assistant III
Beth Israel Deaconess Medical Center
01.2019 - 07.2022
- Answers and triage incoming and outgoing telephone calls.
- Obtains all patient information required by providers prior to an appointment.
- Takes accurate messages or directs call to appropriate person.
- Updates patient demographic and insurance information as necessary.
- Schedules patient appointments utilizing scheduling tools and resources via CCC & OMR.
- Prepares patient records for clinical activities and maintains patient records for physicians.
- Types correspondence, manuscripts and/or others documents.
- Submit prior-authorizations for medication and Radiology Imaging approval to various insurance companies when required.
- Prepare received medical records for scanning in our electronic medical records system.
- Register and/or update demographic, PCP, insurance and other pertinent information for all patients seen in the practice.
- Transcribes letters and patient notes as needed for physicians and facilitates in clinical computer systems.
- Maintains physicians' clinical and administrative schedules and calendars.
Front Store Clerk
CVS
02.2017 - 12.2019
- Assisting customers with their purchase.
- Assisting with Self-Checkout.
- Processing payments.
- Handling customer issues.
- Answering questions about products, policies & services.
- Stocking, Cleaning, Damages, etc.
Patient Service Coordinator III
Massachusetts General Hospital
08.2012 - 12.2019
- Obtains all patient information required by providers prior to an appointment.
- Acting as a resource for other clinical staff.
- Taking action to correct any staff shortcomings.
- Assist in implementing new initiatives and making sure all staff understand them.
- Assist with front desk check in when short staffed.
- Ability to schedule and reschedule all type of appointments, and procedures as necessary, override visit durations, and visit types in accordance with Epic.
- Collects co-pays from patients for the appropriate managed care plans.
- Handle and triage incoming and outgoing phone calls, using customer service skills.
- Work with hospital computer systems Epic, IDX, Patient Keeper, Practice Gateway, Ambulatory Patient Tracking, LMR and NEHEEN.
- Submit prior-authorizations for medication and Radiology Imaging approval to various insurance companies when required.
- Release medical records according to HIPPA privacy laws.
- Prepare received medical records for scanning in our electronic medical records system.
- Register and/or update demographic, PCP, insurance and other pertinent information for all patients seen in the practice.
- Mentors new staff during their onboarding process.
- Assist with training of new staff as it pertains to appropriate triaging of patient calls, clinic paperwork, preparation, appointment scheduling/cancelation/rescheduling.
Customer Service Representative
Maximus Inc.
08.2007 - 01.2011
- Answer incoming calls.
- Assisted Mass Health Members and providers using knowledge gained through training and other resources.
- Answered Mass Health provider or member has related to claims status, PT-1 status, transportation guidelines, member eligibility and managed care status, prior authorization, and pharmacy guidelines and procedures.
Personal Care Attendant (PCA)
Cerebral Palsy of Massachusetts
03.2003 - 07.2007
- Assisted clients with personal hygiene, household duties.
- Assisted clients with medication administration.
- Engaged with social activities like reading, playing games, talking.
- Consulted with the client's family members regarding the clients well being.
Medical Records (Externship for Salter School)
Dimock Community Health Center
09.2006 - 11.2006
- Handled and triaged incoming and outgoing phone calls, using customer service skills.
- Prepared patient records for clinical activities and maintained patient records for physicians.
- Placed lab and x-ray results in proper files.
- Responded to requests in a timely manner and provided clear, accurate information.
Clerical Assistant (High School Summer Internship)
Brigham and Women's Hospital
06.2000 - 08.2000
- Obtained all patient information required by providers prior to an appointment.
- Assisted with front desk check in if department was short staffed.
- Pulled patient charts for archiving.
Education
NATURAL SCIENCE - Nursing
QUINCY COLLEGE
Quincy, MA06-2027
HEALTH CLAIMS SPECIALIST - Coding/ Billing Skills, ICD-9 Coding, CPT-4 Coding, Medical Terminology, Anatomy, Medical Transcription, Microsoft Word, Microsoft Excel
SALTER SCHOOL
Somerville, MA11.2007
High School Diploma - MEDIA ARTS
ENGLISH HIGH SCHOOL
Jamaica Plain, MA06.2002
Skills
- ICD-9 coding
- CPT-4 coding
- Medical terminology
- Health claims processing
- Patient assessment
- Office administration
- Effective communication
- Team collaboration
- Customer service
- Microsoft Excel
- Travel arrangements coordination
- Data entry
- Telephone etiquette
- Managing office supply inventory
- Attention to detail
- Inbound phone call handling
- Calendars management
- Meeting coordination
- Verbal and written communication
- Calendar management
- Appointment scheduling
- Scheduling appointments
- Team leadership
References
References available upon request.
Timeline
Patient Administrative Coordinator
Boston Children's Hospital
08.2023 - Current
Administrative Coordinator/ Surgical Scheduler
Boston Medical Center
07.2022 - 08.2023
Administrative Assistant III
Beth Israel Deaconess Medical Center
01.2019 - 07.2022
Front Store Clerk
CVS
02.2017 - 12.2019
Patient Service Coordinator III
Massachusetts General Hospital
08.2012 - 12.2019
Customer Service Representative
Maximus Inc.
08.2007 - 01.2011
Medical Records (Externship for Salter School)
Dimock Community Health Center
09.2006 - 11.2006
Personal Care Attendant (PCA)
Cerebral Palsy of Massachusetts
03.2003 - 07.2007
Clerical Assistant (High School Summer Internship)
Brigham and Women's Hospital
06.2000 - 08.2000
NATURAL SCIENCE - Nursing
QUINCY COLLEGE
HEALTH CLAIMS SPECIALIST - Coding/ Billing Skills, ICD-9 Coding, CPT-4 Coding, Medical Terminology, Anatomy, Medical Transcription, Microsoft Word, Microsoft Excel
SALTER SCHOOL
High School Diploma - MEDIA ARTS
ENGLISH HIGH SCHOOL
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