Alejandra Bignotte
Miami,FL
Summary
Skilled Referral Coordinator with 15 years of experience managing referrals for Health Care providers. Reputation for skillfully communicating with stressed patients and ensuring full satisfaction. Thrive in a high-volume call center environment.
Detail-oriented and highly organized Referral Coordinator with 15-year history of serving patients in the healthcare setting. Technically savvy and expert user of some software. Interested in contributing to the Healthcare industry.
Overview
17
17
years of professional experience
Work History
Remote Referral Coordinator
Caremax Medical Centers
Miami, FL
06.2023 - Current
- Assisted in the development of referral processes and procedures.
- Conducted outreach to community providers for referrals and resources.
- Maintained accurate records of all referrals, including contact information and follow-up activities.
- Coordinated with external agencies to ensure timely processing of referrals.
- Monitored patient progress throughout the referral process.
- Collaborated with internal departments to ensure smooth transitions for referred patients.
- Performed data entry related to referrals into electronic health record systems.
- Advised staff on appropriate protocols when making a referral.
- Communicated regularly with patients regarding their care plans following a referral.
- Assisted in training new employees on the organization's policies for making referrals.
- Reviewed medical records to determine if additional services are needed prior to making a referral.
- Analyzed patient outcomes data related to specific types of referrals.
- Scheduled patients according to availability, urgency and insurance authorization guidelines.
- Reviewed demographic, clinical and insurance information before sending to referred specialists.
- Reviewed referral details and expectations with providers and patients and requested new referrals when necessary.
- Answered questions and resolved concerns raised by both patients and specialists.
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
- Performed additional office duties, handling patient service inquiries and receiving payments.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Provided guidance to providers regarding the prior authorization process.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Processed appeals in a timely manner as per policy guidelines.
- Maintained accurate records of all authorization activities in the database system.
- Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.
- Facilitated communication between providers, payers and health plans regarding prior authorization processes.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Maintained files for referral and insurance information, entering referrals into system.
- Scheduled patient appointments, diagnostic specialty appointments, tests and procedures.
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
- Answered questions and responded to inquiries to deliver high level of service to patients.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
Front Desk Supervisor/Referral Coordinator/Authorization Specialist
Westchester Pediatric Associate LLC
Miami, FL
07.2007 - 03.2021
- Greeted and welcomed guests in a friendly, professional manner.
- Monitored the front desk staff to ensure proper customer service was provided.
- Provided support to guests with check-in and check-out procedures.
- Assisted guests with inquiries and requests.
- Resolved customer complaints promptly and efficiently.
- Greeted patients, verified insurance coverage and collected copayments.
- Answered phones, scheduled appointments, and provided general information to callers.
- Prepared patient charts for upcoming appointments, including collecting patient history forms and other relevant documents.
- Entered patient demographic information into the Electronic Health Records system.
- Assisted in billing activities by submitting claims electronically, mailing paper claims to payers and following up on unpaid or denied claims.
- Maintained a filing system for patient records and physician orders.
- Processed referrals from primary care physicians and specialists as needed.
- Ordered office supplies and maintained inventory levels of medical supplies.
- Assisted with scheduling diagnostic tests such as X-rays, MRIs, CT scans., when requested by physicians or nurse practitioners.
- Performed data entry tasks including transcribing dictation of medical reports into electronic health records system.
- Scanned documents into EHR systems according to established protocols.
- Compiled statistical reports related to patient visits and procedures for management review.
- Provided administrative support to clinical staff as needed.
- Answered phone calls to provide assistance, information and medical personnel access.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
- Confirmed patient information, collected copays and verified insurance.
- Organized, distributed and replenished office supplies to keep department running efficiently.
- Verified insurance coverage, obtained preauthorizations and updated charts in [Software].
- Communicated with patients via phone, email and in person to obtain payments on outstanding accounts or accounts requiring deductibles or co-pays.
- Created and maintained accurate and confidential patient files according to regulatory mandates.
- Directed patient flow during practice hours, minimizing wait times.
- Updated patient accounts and information daily.
- Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services.
- Scheduled radiology exams for patients.
- Scheduled appointments for patients via phone and in person.
- Communicated with patients to resolve inquiries, schedule appointments and address billing questions.
- Registered patients and scheduled appointments.
- Assisted with referrals and prepared medical records for patients.
- Collected information, verified insurance and collected co-payments for patients as part of check-in process.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Scheduled and confirmed patient appointments and consultations.
- Communicated with patients with compassion while keeping medical information private.
- Greeted patients, determined purpose of visit and directed to appropriate staff.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
Education
Associate of Science - Radiologic Technology
Professional Training Center
Miami, FL05-2007
Some College (No Degree) - Billing And Coding
Professional Training Center
Miami, FLSkills
- Appointment Scheduling
- Insurance precertification processes
- Multi-line phone proficiency
- Accurate Documentation
- Referral tracking
- Insurance Verification
- Medical terminology knowledge
- Patient Scheduling
- Organizational abilities
- Medical Terminology
- HIPAA Regulations
- Critical Thinking
- Administrative Staff Supervision
- Problem-Solving
- Organizational Skills
- Team Collaboration
- Self Motivation
- Attention to Detail
Timeline
Remote Referral Coordinator
Caremax Medical Centers
06.2023 - Current
Front Desk Supervisor/Referral Coordinator/Authorization Specialist
Westchester Pediatric Associate LLC
07.2007 - 03.2021
Associate of Science - Radiologic Technology
Professional Training Center
Some College (No Degree) - Billing And Coding
Professional Training Center