AMY ROBBINS

Support the Care Management team by performing complex administrative and coordination functions for patient assessments, care planning, and ongoing case management. Collaborate with clinical and operational staff, maintain accurate documentation, and facilitate utilization review and managed care processes within the hospital setting. Utilize insurance workflows and customer service expertise within Epic case management systems.

• Coordinate prior authorization requests, ensuring complete documentation for timely utilization review decisions.
• Track medical necessity records and routed cases to nurses for clinical review.
• Enter utilization management data into EHR systems with high accuracy and confidentiality.

• Assisted with daily living activities and mobility, enhancing safety and comfort for elderly individual
• Managed medication schedules and health monitoring, providing clear documentation of changes for family and healthcare providers
• Coordinated appointments and care routines, facilitating adherence to medical instructions
• Assisted with daily living activities and mobility, ensuring safety and comfort for an elderly individual

• Conducted patient interviews to verify demographic and insurance information, ensuring accurate EHR data entry and compliance with Medicare and payer requirements
• Reviewed third-party coverage and communicated potential out-of-pocket expenses, assisting uninsured patients with financial assistance programs
• Managed pre-registration, pre-admission, and admission processes across multiple access channels
• Collected copayments and patient balances, maintaining accurate daily cash drawer operations
• Cross-trained to support registration workflows in Imaging, CVICU, EKG, and Admitting, providing coverage and operational support

• Managed front office operations, including preparation of cost proposals, reporting equipment malfunctions, and maintaining administrative workflows
• Generated and processed invoices for purchases and accounts payable, ensuring accuracy and compliance with internal procedures
• Served as backup payroll coordinator, supporting timely payroll processing and maintaining operational continuity
• Acted as first point of contact, professionally handling inquiries from staff, vendors, and the public
• Prepared administrative reports, coordinated office supply inventory, and managed high-volume incoming calls to ensure smooth daily operations

• Processed DME prescription authorizations from Kaiser Permanente medical staff while verifying ICD-9 and HCPCS coding accuracy, insurance eligibility, benefits, and medical necessity in accordance with CMS and DMEPOS guidelines
• Optimized workflow by ordering required durable medical equipment through approved external vendors or coordinating internal clinical reviews and prior authorizations to ensure timely approvals
• Maintained ongoing follow-up for equipment renewals, denials, appeals, deliveries, and purchases, ensuring continuity of care and compliance with payer requirements
• Responded to high-volume DME-related calls from members, vendors, nurses, physicians, and medical staff across Northern California, providing patient education, resolving coverage issues, and facilitating equipment coordination