Amy Brunner
Dodgeville,WI
Summary
Dynamic Prior Authorization/Central Scheduling Specialist at Upland Hills Health with a proven track record in optimizing appointment scheduling and enhancing patient relations. Expert in HIPAA compliance and insurance verification, I excel at streamlining processes and ensuring accuracy, resulting in improved patient satisfaction and operational efficiency. Passionate about delivering exceptional healthcare experiences.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Prior Authorization/Central Scheduling Specialist
Upland Hills Health
Dodgeville, WI
11.2005 - Current
- Developed and maintained scheduling system procedures to ensure accuracy of patient information.
- Created, updated, and managed schedules for multiple providers across various departments.
- Coordinated with other departments to ensure timely appointment availability.
- Answered incoming calls from patients regarding appointments or changes to their schedule.
- Provided assistance with the registration process for new patients, including insurance verification.
- Maintained accurate records of patient demographics, insurance information, and appointment data in the database system.
- Monitored daily workflow to identify any potential scheduling problems before they occurred.
- Resolved conflicts between physicians' schedules and patient appointments.
- Communicated effectively with both internal and external customers to provide a positive experience.
- Adhered strictly to HIPAA regulations while handling confidential patient information.
- Reviewed physician orders for accuracy prior to entering into the system.
- Worked collaboratively with other departments in order to maintain an efficient workflow throughout the organization.
- Assisted patients with canceling and rescheduling appointments.
- Instructed patients regarding how to prepare for appointments.
- Coordinated appointments with customers and staff members according to availability.
- Answered phone calls and took messages for staff members.
- Updated patient information in databases and adhered to confidentiality requirements.
- Followed up with patients and confirmed appointments.
- Routed calls and correspondence to appropriate medical staff.
- Prevented double bookings and set aside appropriate time in between appointments.
- Reviewed insurance information with patients and processed copays.
- Informed patients regarding needed medical tests and procedures.
- Updated patient records with appointment and billing information promptly.
- Provided administrative support to medical staff, including document preparation and patient communication.
- Communicated effectively with patients regarding appointment details, preparation instructions, and follow-up care.
- Ensured compliance with facility policies and procedures related to patient scheduling.
- Coordinated scheduling for multiple physicians across various specialties, balancing patient needs and doctor availability.
- Collaborated with medical staff to identify and implement scheduling process improvements.
- Coordinated with insurance companies to verify coverage and obtain necessary pre-authorizations.
- Developed and maintained scheduling templates and guidelines to improve efficiency.
- Managed appointment cancellations and rescheduling, minimizing gaps in physicians' schedules.
- Utilized electronic medical records (EMR) systems for accurate and up-to-date scheduling information.
- Handled incoming calls and inquiries from patients, providing timely and accurate information.
- 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.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
- Processed payments and updated accounts to reflect balance changes.
- Utilized electronic health record systems to maintain accurate patient information.
- Reviewed prior authorization requests for medical services and procedures.
- Communicated with healthcare providers to obtain necessary documentation.
- Evaluated patient eligibility for insurance coverage and benefits.
- Maintained accurate records in electronic health systems and databases.
- Coordinated with insurance companies to clarify coverage policies and requirements.
- Ensured compliance with regulatory standards in all authorization processes.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Provided guidance to providers regarding the prior authorization process.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Maintained files for referral and insurance information, entering referrals into system.
- Facilitated communication between providers, payers and health plans regarding prior authorization processes.
- Input claim, prior authorization, and other important medical data into system.
- Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation.
Education
Certificate - ICD 9 And CPT Coding
US Career Institute
05-2013
Health Unit Coordination
Washtenaw Community College
Ann Arbor, MI12-1992
Some College (No Degree) - Elementary Education
WMU
Kalamazoo, MISkills
- HIPAA Compliance
- Appointment Scheduling
- Calendar Management
- Insurance Verification
- Patient Registration
- Schedule Management
- Strong Organization
- Database Maintenance
- Patient Relations
- Medical Terminology
- Patient Scheduling
- Prior authorization processing
Certification
- Certified Health Unit Coordinator
- Certified in ICD 9 Coding
Education and Training
other,other
Timeline
Prior Authorization/Central Scheduling Specialist
Upland Hills Health
11.2005 - Current
Certificate - ICD 9 And CPT Coding
US Career Institute
Health Unit Coordination
Washtenaw Community College
Some College (No Degree) - Elementary Education
WMU