April Miller
Ponca City,OK
Summary
Referral Coordination Specialist with experience in managing patient referrals and ensuring seamless transitions within healthcare systems. Proven ability to collaborate effectively with team members, adapt to changing needs, and drive successful outcomes. Strong skills in communication, organization, and problem-solving, consistently fostering trust and reliability. Valued for results-driven approach and exceptional interpersonal skills.
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise in the field of prior authorizations.
Overview
19
19
years of professional experience
Work History
Patient Referral Coordinator
Alliance Health Medical Group/Integris Health
03.2023 - Current
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Streamlined referral process by implementing efficient tracking and communication systems.
- Enhanced patient satisfaction with timely coordination of referrals and appointments.
- Reduced wait times for specialist appointments by proactively identifying available slots and coordinating schedules.
- Maintained a high level of accuracy in referral documentation, ensuring smooth transitions between healthcare providers.
- Collaborated with medical staff to ensure appropriate referrals based on individual patient needs and insurance coverage.
- Managed electronic health records efficiently, safeguarding sensitive patient information while expediting the referral process.
- Kept healthcare providers informed of referral status updates, promoting optimal continuity of care throughout the referral process.
- Developed comprehensive knowledge of insurance requirements, advocating for patients when necessary to secure approval for needed services.
Obgyn Medical Coder
Alliance Health Medical Group
06.2022 - 03.2023
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Patient Access Representative
Alliance Health Medical Group/Integris Health
06.2022 - 03.2023
- Completed clerical duties and tasks for clinic administration.
- Verified and updated demographic and other personal information for clients with respect to personal boundaries when asking for important details.
- Used computer programs and registration systems to schedule patients for routine and complex procedures.
- Remained aware of provider schedules and scope of practice on evolving basis to organize and schedule appropriate care.
- Offered ample support to team members with creative solutions to complex challenges regarding scheduling, conflict resolution and medical care.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Managed multi-line phone system and pleasantly greeted patients.
- Checked patient insurance, demographic and health history to keep information current.
- Obtained payments from patients and scanned identification and insurance cards.
Medical Review Specialist (CAC)
Mediclaims Inc.
04.2011 - 06.2021
- Maintained accuracy, completeness and security for medical records and health information.
- Utilized WPS, CMS, NGS and other insurance portals to manage and confirm patient data, such as insurance and demographic information.
- Interacted and communicated easily with department personnel and public.
- Communicated effectively with staff, patients and insurance companies by email and telephone.
- Reviewed patient care reports and flagged for incomplete or inaccurate information according to Medicare and Medicaid guidelines in regards to ambulance billing.
- Worked strict deadlines and provided activity reports to providers.
- Used ICD-10 manuals to gain additional knowledge of disease and diagnoses processes to accurately code ambulance care reports.
- Handled day-to-day running of Medical Review, ensuring high levels of productivity and progression to meet appeal deadlines in denial process.
- Proved successful working within tight deadlines and fast-paced atmosphere.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
- Actively listened to patients and providers, handled concerns quickly and escalated major issues to supervisor.
- Implemented performance improvement strategies and plans to promote continuous improvement.
Customer Service Representative
Sykes AT&T
01.2007 - 09.2010
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions.
- Managed over 50 customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
Certified Medication Aide/Certified Nursing Assistant
Billings Fairchild Center
03.2006 - 08.2010
- Checked patient vitals such as temperature, blood pressure and blood sugar levels.
- Documented care actions by completing records and logs in medical software system.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Helped patients effectively manage routine bathing, grooming and other hygiene needs.
- Reported unusual or urgent circumstances in patients' condition or environment immediately to nurse supervisor.
- Wiped down equipment with proper cleaning products after each patient transport to reduce instances of infection.
- Agreed to take on additional shifts and extra hours during busy periods and holidays to maintain proper staffing and floor coverage.
- Evaluated patients to identify and address wounds, behavioral concerns and medically relevant symptoms.
- Kept detailed records of nursing assessments, administered treatments and medication, discharge procedures and follow-up care needs.
- Coordinated daily medicine schedules and administration to help clients address symptoms and enhance quality of life.
- Reported changes in patient status regarding drug therapy.
- Increased medication and medical terminology knowledge through research and continuing education.
- Administered prescribed drugs to high-volume patient case load in 154 bed facility, also filling in as needed as sub medication aide across three halls.
Education
Ambulance Coder -
National Academy of Ambulance Compliance
Mechanicsburg, PA03.2020
GED -
Pinellas Technical Education Center
Clearwater, FL10.2002
Skills
- Data Entry
- Medical Manager, Docuware, EPIC, Athena and Ingenious systems
- Ambulance and OB/GYN medical coding/billing
- Reception
- Patient Care
- Caseload Management
- Appointment Scheduling
- Insurance Verification
- Follow-up Coordination
- Referral Verification
Timeline
Patient Referral Coordinator
Alliance Health Medical Group/Integris Health
03.2023 - Current
Obgyn Medical Coder
Alliance Health Medical Group
06.2022 - 03.2023
Patient Access Representative
Alliance Health Medical Group/Integris Health
06.2022 - 03.2023
Medical Review Specialist (CAC)
Mediclaims Inc.
04.2011 - 06.2021
Customer Service Representative
Sykes AT&T
01.2007 - 09.2010
Certified Medication Aide/Certified Nursing Assistant
Billings Fairchild Center
03.2006 - 08.2010
Ambulance Coder -
National Academy of Ambulance Compliance
GED -
Pinellas Technical Education Center
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