Medical Records Retrieval for PI, WC and NH, Medical Scheduling/Receptionist WC a

Experienced in handling high-volume inbound calls to assist patients, insurance representatives, defense attorney representatives, and hospital/facility staff with scheduling, rescheduling, and canceling medical appointments. Verifying insurance information on where to bill the services properly. Skilled in making outbound calls to hospitals, facilities, and clients to obtain or provide appointment details, including status updates and location information. Responsible for requesting and following up on medical scripts via fax and email as needed. Proficient in using Ramsoft CRM to manage and track appointment workflows efficiently. For EOL, responsible for coordinating with various medical facilities across Pennsylvania to schedule clients for treatment related to personal injury (PI) or workers’ compensation (WC) cases. This includes identifying the appropriate type of care, such as orthopedics, physical therapy, or neurology, and ensuring timely communication. Regularly send appointment confirmations and updates via email and text to clients and their legal representatives. Proficient in using Salesforce and Doctor Map.

Experienced in preparing and sending HCFA bills along with demand letters to handling adjusters and defense attorneys to facilitate the settlement of workers' compensation (WC) claims. Proficient and knowledgeable in using Daisybill as a CRM tool to manage claims, monitor case status, and send timely follow-up emails. Skilled in negotiating and closing claims efficiently, with a strong focus on resolution before the litigation period begins.

Experienced in requesting medical records from a wide range of sources, including hospitals, nursing homes, imaging centers, and third-party services such as MRO, CIOX, Verisma, ScanSTAT, and ChartSwap. This also includes obtaining ambulatory reports and coordinating with opposing counsel for necessary documentation. Requests are submitted through various channels, including email, fax, phone calls, and online portals. Responsibilities include monitoring the status of requests, ensuring receipt by the facility, and resending when necessary. I am also well-versed in providing appropriate documentation and HIPAA forms to authorize the release of confidential records. In cases of non-compliance, I prepare and file OCR complaints to address delayed record releases. Once obtained, medical records are saved and organized in the CRM system for attorney review. I regularly communicate with attorneys to identify missing records or specific dates of service that require follow-up. Additionally, I compile complete medical record packets—organized both alphabetically and chronologically (from most recent to oldest)—to support attorneys in preparation for depositions or hearings.

Focused on ensuring that the team consistently meets company goals while staying aligned with the organization’s mission and vision. Dedicated to fostering a positive and supportive work environment that encourages both personal and professional growth. Actively collaborate with the team to set clear objectives, delegate tasks effectively, and ensure everyone is equipped with the necessary training and resources to maintain high-quality work. Monitor team attendance and track performance on a daily, weekly, and monthly basis to ensure productivity standards are met. Responsible for compiling and submitting performance reports to upper management, including quarterly evaluations that identify team members who may need additional support or recognition. Present monthly performance summaries and bonus recommendations, ensuring that deserving team members are fairly acknowledged and rewarded.