AMY HUDSON
Glendale,AZ
Summary
Dependable Prior Authorization Specialist with a career spent handling various administrative responsibilities in fast-paced settings. Bilingual individual dedicated to finding solutions to issues and obtaining prior authorization information for patients. Ready to tackle new challenges in an office-based environment. Reliable professional offering an extensive career promoting positive customer experiences. Sharp Eligibility Specialist boasting expertise in managing and eligibility information for members and groups. Detail-oriented Prior Authorization Specialist proudly offering over 20 years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments.
Overview
21
21
years of professional experience
Work History
PRIO AUTHORIZATION
Banner Healthcare
Gilbert, AZ
04.2019 - Current
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Used [Software] to input claim, prior authorization and other important medical data into system.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Maintained positive working relationship with fellow staff and management.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Notified ordering providers of denied authorizations.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
- Answered questions and responded to inquiries to deliver high level of service to patients.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Understood and followed oral and written directions.
- Completed day-to-day duties accurately and efficiently.
- Prioritized and organized tasks to efficiently accomplish service goals.
Medicare Billing Specialist
Preferred Healthcare
Tempe, AZ
11.2016 - 03.2019
- Maintained a working knowledge of CPT and HCPCS codes, ICD-10 codes, modifiers, fee schedules, insurance plans.
- Performed eligibility verifications for Medicare patients utilizing online databases.
- Applied HIPAA privacy and security regulations while handling patient information.
- Leveraged EMR software to post payments received for medical services.
Office Manager
Sun Radiology
Glendale, AZ
10.2015 - 11.2016
- Managed office inventory and placed new supply orders.
- Provided administrative support to management team including preparing reports and presentations.
- Interpreted and communicated work procedures and company policies to staff.
- Supervised staff members, organized schedules and delegated tasks.
- Produced thorough, accurate and timely reports of project activities.
- Planned and delivered training sessions to improve employee effectiveness and address areas of weakness.
- Reviewed employee performance and provided ongoing feedback and coaching to drive performance improvement.
- Assigned work and monitored performance of project personnel.
- Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
- Interviewed prospective employees and provided input to HR on hiring decisions.
PAS-REGISTRATION
Banner Heart Hospital
Glendale, AZ
05.2003 - 09.2015
- Utilized knowledge of Medicare and Medicaid regulations to ensure compliance with billing practices.
- Processed daily reports including census report, aging report, collection report and charge entry report.
- Scanned documents into EMR system; updated and maintained files according to established protocol.
- Asked various questions from clients to obtain the information necessary for paperwork.
- Maintained confidentiality of protected health information according to HIPAA guidelines.
- Adhered to department policies and procedures as well as established safety protocols.
- Registered patients for outpatient procedures and emergency services.
- Processed cash, debit and credit card payments for services rendered and printed receipts detailing services.
Medicare Billing Specialist
PREFERRED HEALTH MEDICAL SUPPLY
Tempe, AZ
Education
Some College (No Degree) - General Studies
Glendale Community College
Glendale, CASkills
- Customer Relations
- Team Management
- Friendly, Positive Attitude
- Problem Resolution
- Dependable and Responsible
- Troubleshooting
- Organization and Time Management
- Communication
- Organization
- Time Management
- Problem-Solving
Timeline
PRIO AUTHORIZATION
Banner Healthcare
04.2019 - Current
Medicare Billing Specialist
Preferred Healthcare
11.2016 - 03.2019
Office Manager
Sun Radiology
10.2015 - 11.2016
PAS-REGISTRATION
Banner Heart Hospital
05.2003 - 09.2015
Medicare Billing Specialist
PREFERRED HEALTH MEDICAL SUPPLY
Some College (No Degree) - General Studies
Glendale Community College