Alisa Street

• Assisted in managing the development and implementation of the Iplan Knowledge Base project to enhance revenue forecasting accuracy by facilitating correct iplan selection during patient registration.

• Assisted in managing the development and implementation of numerous automations for Iplan Knowledge Base, Authorization, and Notice of Admission.

• Coordinated with manager and director to streamline information processes, contributing to enhanced departmental efficiency and effectiveness.
• Conducted thorough reviews of daily, weekly, and monthly reports to ensure accuracy and effectiveness of automation systems.
• Exercised meticulous attention to detail to guarantee data accuracy in reporting.
• Performed detailed audits aimed at identifying inefficiencies within review processes.

• · Perform post notification and insurance verification after 72 hours of receipt of notification for both inpatient and outpatient services.
• · Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein.
• · Contact physician to resolve issues regarding prior authorization or referral forms.
• · Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues.
• · Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility.
• · Work accounts identified via the Meditech reports efficiently and efficiently on a daily basic to resolve accounts with no authorization on file, ALOS versus authorized days variances
• · Accurate and concise documents all communication and action considered in accordance with policies and procedures
• Work assigned accounts in eRequest to resolve outstanding issues
• · Contact the facilities and/or Insurance companies to resolve denials/appeals

• Assisted in obtaining insurance pre-certification verification. Conducted patient interviews prior to surgery.
• Ensured accurate verification of patient eligibility and authorization benefits to facilitate seamless claims processing.
• Provided timely updates to patients regarding benefit verification information to enhance understanding of financial obligations.