Ashley Staton
Cockeysville,MD
Summary
Organized Practice Coordinator known for high productivity and efficient task completion. Skilled in patient scheduling, records management, and office administration. Excel at communication, teamwork, and problem-solving to ensure smooth practice operations.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Sr. Ambulatory Practice Coordinator I Cancer Ctr
University Of Maryland Medical System
Towson, Maryland
01.2024 - Current
- Review and interpret physician orders and patient medical records to determine the necessity and accuracy of prior authorization requests
- Contact insurance providers to verify patient coverage and benefits specific to prescribed medications and treatments
- Submit detailed authorization requests through electronic health records (EHR) systems, online portals, or via telephone
- Collaborate with healthcare providers to gather additional information or clarification needed for prior authorization submissions
- Monitor and track the status of submitted authorizations, following up as necessary to resolve delays or issues that may arise
- Communicate effectively with patients regarding the status of their authorization, including any additional information or action required on their part
- Adhere to all healthcare regulations, including HIPAA, to ensure patient privacy and the confidentiality of medical information
- Refer underinsured/uninsured patients and/or point-of-service pre-payment required services to the Pre-Service Patient Financial Responsibility and/or Financial Assistance Department to determine if the patient is eligible for assistance and obtain payment before services are received, when applicable, to help manage the organization's bad debt
- Acts as an expert user of the Epic system for the practice regularly attends meetings, and shares pertinent upgrade and enhancement information with teams
- Accurately completes patient registration responsibilities to include confirming/updating patient demographics and insurance information
- Schedules patient appointments following physician and practice schedules
- Efficiently review denial reports and provide follow-up to leadership
- Educates and provides patients with facility fee disclosure, an estimate of charges, and a financial fee acknowledgment form
- Exhibits and maintains professionalism throughout all interactions
- Ability to successfully communicate with all internal and external customers
- Professionally offer constructive feedback and suggestions to improve processes and resolve conflicts
- Acts as an active listener and can convey clear messages verbally and in written format
- Maintains professional, open, and non-judgmental body language
- Treats everyone respectfully to build and maintain trust
- Demonstrates a strong and consistent moral code and meets commitments
- Leads process improvement initiatives within the practice
- Continues to be open to change and new ideas
- Proactive in the pursuit of ideas and their transformation into practice
- Engages the team in process improvement initiatives and supports change management
Ambulatory Practice Coordinator II, Cancer Ctr
University Of Maryland Medical System
Towson, Maryland
05.2021 - 01.2024
- Responsible for the insurance verification process of verifying patient eligibility, and coordinating medical benefits
- Contact insurance companies to obtain benefits for possible services related to the patient’s diagnosis
- Informs patients, providers, and staff of benefits as appropriate
- Obtains authorizations for outpatient chemotherapy (injectable and infusible)
- Monitor changes in Medicare and other insurance guidelines to ensure compliance
- Complies with Epic scheduling standards
- Monitors overbooking and/or conflicting scheduling situations and informs the Business Supervisor
- Attends training sessions via webinar as appropriate
- Provides relevant clinical information to insurance companies as needed
- Completes accurate and thorough documentation of all authorization-related matters in EMR
- Maintains insurance-related office forms
- Works closely with the Hospital Financial Assistance Coordinators to enroll patients in financial assistance programs
- Works closely with providers to overturn denials
- Schedules peer-to-peer reviews as needed for insurance denials
- Coordinates with the physicians, nurse navigators, and department management to keep office processes functioning smoothly
- Identifies and solves problems appropriately through strong initiative and proactive means
- Processes all referral requests by physicians and patients promptly and according to clinical procedure
- Communicates effectively with the manager on a day-to-day basis
- Verifies patient benefits and eligibility before completing referral
- Provide coverage with patient registration, check-in and check-out process, and greet patients
- Call center coverage taking patient calls, processing/logging them in the system, and communicating routing calls in a timely and precise manner
- Maintain referral work queue
- Provides guidance and instruction to fellow employees where skills need improvement, as needed
- Provides information to the Business Supervisor regarding work progress, actions, and issues in a timely and effective manner
- Process inpatient to new patient consult visits
- Schedule new patients, and obtain medical records for new consults
- Assists Business Supervisor in conducting orientation and training of new employees
- Actively and continuously improves work processes
Medical Secretary II
University Of Maryland Medical System
Towson, Maryland
10.2017 - 05.2021
- Assist with coordinating patients with patient registration, check-in and check-out process, greet patients, verify demographic information, and inform staff of arrival
- Generates encounters and other needed paperwork
- Reviews need for referral authorizations, pre-authorization, and/or obtains information that may be requested by other staff to ensure acquisition of these documents
- Use facility correspondence websites, phone, and/or correspondence to contact payers to expedite the collection process and ensure pre-authorization requirements are met
- Obtains additional office notes, EKGs, and sleep studies as needed for the provider and other staff
- Initiates any insurance carrier regulatory needs such as advance beneficiary notices or waivers of liability and forwards to appropriate staff for completion and/or discussion with the patient
- Reschedules and contact the patient as needed, for continuity of care
- Review and/or audit accounts to determine the status and appropriate action required from workflow generated from the EPIC system
- Develop and maintain positive working relationships and partnerships with internal and external customers by providing superior customer service
Patient Registar
UMMC Midtown Campus
Baltimore, Maryland
05.2015 - 10.2017
- Scheduled patients for admissions, evaluations, and re-evaluations by physicians’ schedules, managed care contracts and received referrals from social workers, discharge planners, physicians, and physician’s offices
- Trained onboarding Administrative Staff
- Obtained pre-authorizations for insurance, and added demographic information into the appropriate medical/scheduling system
- Verified patient benefits and eligibility before completing referrals; Reminded patients of upcoming appointments, and made changes to schedules
- Collected co-payments, and requested medical records; provided patients, family members, and referral sources with information about hospital policies and procedures, programs available, and locations
- Coordinated patient transfers from other local hospitals to the Diabetes & Endocrinology clinic
- Created, edited, and deleted Provider templates
- Campaigned for Primary Care Physician-a-ton, Child and Nutrition health board; Created Rapid Response log, walk-in patient log, and MSDS binder, maintained inventory and order supplies, and performed other related duties as required
Education
HIgh school diploma -
Oakland Mills High
Skills
- Medical terminology
- Office administration
- HIPAA compliance
- Insurance verification
- Patient scheduling
- Appointment coordination
- Referral management
- Staff development
- Strategic planning
- Schedule management
- New hire training
Certification
Prior Authorization Certified Specialist (PACS)
Committeeinvolvement
- Front Desk Taskforce, Chair
- Sunshine Committee, Chair
- Northern Super User Meeting, Member
- Professional Development Council, Member
Timeline
Sr. Ambulatory Practice Coordinator I Cancer Ctr
University Of Maryland Medical System
01.2024 - Current
Ambulatory Practice Coordinator II, Cancer Ctr
University Of Maryland Medical System
05.2021 - 01.2024
Medical Secretary II
University Of Maryland Medical System
10.2017 - 05.2021
Patient Registar
UMMC Midtown Campus
05.2015 - 10.2017
HIgh school diploma -
Oakland Mills High