Andrew Genovese
Queensbury,NY
Summary
To become part of a progressive growth oriented organization where my abilities and overall knowledge will be optimally utilized.
Overview
19
19
years of professional experience
Work History
Prior Authorization Specialist
Glens Falls Hospital
Glens Falls, NY
06.2022 - 05.2023
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Developed and maintained productive working relationships with healthcare providers.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
Telemetry PCA
Glens Falls Hospital
Glens Falls, NY
10.2019 - 05.2023
- Helped patients maintain healthy skin by checking wounds, assessing integrity, and bathing bedbound individuals.
- Planned, prepared, and served meals and snacks according to prescribed diets.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Maximized patient satisfaction by helping individuals carry out personal tasks such as dressing and walking.
- Recorded temperature, blood pressure, pulse, or respiration rate as directed by medical or nursing staff.
- Answered patient assistance calls, assessed needs, and offered qualified support.
- Collected and transported specimens to prepare for lab testing.
- Organized and replenished unit supplies to maintain team readiness for expected demands.
- Obtained patient vital signs and reported results to staff nurse or physician, noting changes from prior measurements.
Patient Access Representative Emergency Department
Glens Falls Hospital
Glens Falls, NY
05.2018 - 10.2019
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Providing excellent customer service by promptly answering patient inquiries.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Trained new staff on hospital processes and procedures.
- Verified patient insurance eligibility and entered patient information into system.
- Greeted and assisted patients with check-in procedures.
- Provided excellent customer service to patients and medical staff.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
Owner/General Manager
Superior Cantina
Glens Falls, NY
01.2015 - 12.2017
- Managed day-to-day business operations.
- Consulted with customers to assess needs and propose optimal solutions.
- Trained and motivated employees to perform daily business functions.
- Evaluated suppliers to maintain cost controls and improve operations.
- Enhanced operational efficiency and productivity by managing budgets, accounts, and costs.
- Oversaw business budget planning and administration, accounting functions, purchasing, and bi-weekly payroll to handle financial needs.
- Developed and implemented marketing strategies to generate new customers and increase sales and profit margins.
Store Manager
RadioShack
Queensbury, NY
05.2009 - 01.2015
- Managed inventory control, cash control, and store opening and closing procedures.
- Managed store employees successfully in fast-paced environment through proactive communication and positive feedback.
- Completed point of sale opening and closing procedures.
- Rotated merchandise and displays to feature new products and promotions.
- Maintained proper product levels and inventory controls for merchandise and organized backroom to facilitate effective ordering and stock rotation.
- Assisted with hiring, training and mentoring new staff members.
- Maximized sales and minimized shrinkage through excellent customer service and adherence to standard practices.
- Approved regular payroll submissions for employees.
- Set effective store schedules based on forecasted customer levels, individual employee knowledge, and service requirements.
- Coached sales associates in product specifications, sales incentives, and selling techniques, significantly increasing customer satisfaction ratings.
- Reconciled daily sales transactions to balance and log day-to-day revenue.
- Promoted team collaboration, performance, and efficiency by fostering healthy environments focused on mutual success.
- Supervised guests at front counter, answering questions regarding products.
- Trained new employees on proper protocols and customer service standards.
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
- Interacted well with customers to build connections and nurture relationships.
- Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.
Assistant General Manager
W Hotel
Tucson, AZ
03.2004 - 01.2009
- Handled cash accurately and prepared deposits.
- Motivated, trained, and disciplined employees to maximize performance.
- Resolved problems promptly to elevate customer approval.
- Managed team schedule with eye for coverage needs and individual strengths.
- Trained new employees on proper protocols and customer service standards.
- Interacted well with customers to build connections and nurture relationships.
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
Education
Bachelor of Science - Hotel, Motel, And Restaurant Management
Northern Arizona University
Flagstaff, AZ05.2006
Skills
- Patient Identification
- Office Supplies and Inventory
- Health Insurance Plan Knowledge
- Diagnostic Codes
- Private Insurance
- Authorizations
- Retro-Authorizations
- Customer Relations
- Payroll Administration and Timekeeping
- Profit and Loss
- Mentoring
Timeline
Prior Authorization Specialist
Glens Falls Hospital
06.2022 - 05.2023
Telemetry PCA
Glens Falls Hospital
10.2019 - 05.2023
Patient Access Representative Emergency Department
Glens Falls Hospital
05.2018 - 10.2019
Owner/General Manager
Superior Cantina
01.2015 - 12.2017
Store Manager
RadioShack
05.2009 - 01.2015
Assistant General Manager
W Hotel
03.2004 - 01.2009
Bachelor of Science - Hotel, Motel, And Restaurant Management
Northern Arizona University