Ashley Jameson
Bend
Summary
Dynamic and detail-oriented professional with extensive experience in healthcare administration, seeking a position as a Hospital Authorization Specialist in a general medical facility. Proven ability to efficiently manage authorization processes while ensuring compliance with regulations and enhancing patient care. Committed to leveraging strong analytical skills and industry knowledge to contribute to organizational success and foster professional growth. Eager to support the team in delivering exceptional service and optimizing operational efficiency.
Overview
13
13
years of professional experience
Work History
Hospital Authorization Specialist
Pulse Heart Institute
Tacoma, WA
03.2023 - Current
- Initiates, submits, and tracks referrals/authorizations for Electrophysiology, Heart Failure, and General Cardiology procedures
- Utilizes knowledge in CPT and ICD-10 codes to accurately code procedures and diagnosis
- Reviews medical records for compliance, gathering all proper clinicals pertaining to the procedure for authorization purposes
- Verifies patient insurance eligibility and benefits
- Understands and utilizes multiple insurance platforms/portals
- Able to learn about new procedures and establish a new work flow for authorizing said procedures
- Effectively communicates between clinicians, insurers, patients to resolve any records deficiencies, denials, or requested appeals
Surgery/Referral Coordinator
Surgical Associates Northwest - Division of Urology
Federal Way, WA
07.2022 - 09.2022
- Processes incoming and outgoing referrals.
- Ordering of any labs/diagnostic imaging needed pre-op.
- Communicates with insurance companies in order to obtain patient's eligibility/benefits and authorizations
- Ensures that ICD-10 codes and CPT codes are accurate on authorization requests by utilizing information from both clinical and billing documentation.
- Maintains continuous contact between the provider(s), patient, and hospital regarding surgery and insurance/financial details.
- Creates new patient accounts using Health Wind and All Scripts software.
- Familiar with OneHealthPort, Availity, AIM, Evicore, and United Health Care sites.
- Sends out surgery packet with all surgery details and also calls the patient to counsel them on medication, food, and fluid intake.
- Processes referrals for new patients as well as referring current patients to other medical providers.
Administrative Assistant
F.S. and G.S. Services, Inc
Puyallup, WA
07.2018 - 04.2019
- Managed and organized company file systems.
- Answered and directed incoming calls to appropriate personnel.
- Close-Out of Project: Collect, assemble and submit all required project data for owner and/or contractor.
- Assisted with company payroll utilizing Microsoft Excel to track employee hours.
- Asbestos Survey Reports: Collect, assemble, bill, and distribute results to the property owner and/or contractor.
- Prepared billing for waste management using Microsoft Excel.
- Process payments from contractors and other clients.
- Prepared written reports when asked using Microsoft Word.
- Used Microsoft Outlook to correspond e-mails and keep track of the estimator's schedules.
- Entered company inventory data into Construction Partner, assigning materials to the appropriate job.
Medical Records Assistant
Life Care Center of South Hill
Puyallup, WA
07.2013 - 05.2017
- Preserved patient confidentiality at all times.
- Proficiently coded patient diagnosis using ICD-9/ICD-10.
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation by utilizing a variety of audits.
- Assisted in the establishment and maintenance of medical charts and/or electronic medical record (inputting physician orders, filing medical documents in the appropriate area of chart, thinning of records).
- Adhered to all facility, company and legal guidelines.
- Assembled and archived discharge records
- Calculated daily facility census
- Obtained patient releases for dissemination of information, ensuring that any release of information was HIPAA compliant.
- Scheduled patient appointments and transportation if needed.
- Maintained the Master Patient Index
Education
Associate of Health Information and Technology - Health Information and Technology
Kaplan University
Davenport, IA01-2013
Skills
- Meticulous attention to detail
- Efficient prior authorization management
- Insurance eligibility verification
- Data entry expertise
- ICD-10 and CPT coding skills
- Proficient in Microsoft Office
- Effective communication skills
- Experienced with multi-payer systems
- Skilled in Epic systems
- Medical Terminology
- HIPAA compliance
Additional Information
Authorized to work in the US for any employer
Timeline
Hospital Authorization Specialist
Pulse Heart Institute
03.2023 - Current
Surgery/Referral Coordinator
Surgical Associates Northwest - Division of Urology
07.2022 - 09.2022
Administrative Assistant
F.S. and G.S. Services, Inc
07.2018 - 04.2019
Medical Records Assistant
Life Care Center of South Hill
07.2013 - 05.2017
Associate of Health Information and Technology - Health Information and Technology
Kaplan University