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
University Of Maryland Medical System
Baltimore, MD
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 or 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 to 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, including confirming and updating patient demographics and insurance information.
- 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.
- Professionally offer constructive feedback and suggestions to improve processes, and resolve conflicts.
- Engages the team in process improvement initiatives, and supports change management.
Ambulatory Practice Coordinator II
University Of Maryland Medical System
Baltimore, MD
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 the 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 the referral.
- Provide coverage for patient registration, check-in, and check-out processes, and greet patients.
- Call center coverage involves taking patient calls, processing and logging them in the system, and communicating routing calls in a timely and precise manner.
- Maintain the 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, effective manner.
- Process inpatient to new patient consult visits.
- Schedule new patients, and obtain medical records for new consults.
- Assists the Business Supervisor in conducting orientation and training for new employees.
- Actively and continuously improve work processes.
Medical Secretary II
University Of Maryland Medical System
Towson, MD
10.2017 - 05.2021
- Assist with coordinating patients with patient registration, check-in, and check-out processes, greet patients, verify demographic information, and inform staff of arrivals.
- Generates encounters and other needed paperwork.
- Reviews need for referral authorizations, pre-authorization, and/or obtaining information that may be requested by other staff to ensure the 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 for the provider and other staff.
- Initiates any insurance carrier regulatory needs, such as advance beneficiary notices or liability waivers, and forwards them to the appropriate staff for completion and/or discussion with the patient.
- Reschedule and contact the patient as needed for continuity of care.
- Review and/or audit accounts to determine the status and appropriate action required from the workflow generated by the EPIC system.
- Develop and maintain positive working relationships and partnerships with internal and external customers by providing superior customer service.
Patient Registrar
University of Maryland Midtown Campus
Baltimore, MD
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 physicians' offices.
- Trained onboarding of administrative staff.
- Obtained pre-authorizations for insurance, and added demographic information into the appropriate medical and 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 and Endocrinology clinic.
- Created, edited, and deleted provider templates.
- Campaigned for the Primary Care Physician-a-thon, Child and Nutrition Health Board.
- Created a Rapid Response log, a walk-in patient log, and an MSDS binder; maintained inventory and ordered supplies; and performed other related duties as required.
Education
High School Diploma -
Oakland Mills High
Skills
- Appointment coordination
- Insurance verification
- Marketing support
- HIPAA compliance
- Medical terminology
- Office Administration
- Patient scheduling
- Referral management
- Insurance referral facilitation
- Schedule management
- Continuous improvement
- 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
University Of Maryland Medical System
01.2024 - Current
Ambulatory Practice Coordinator II
University Of Maryland Medical System
05.2021 - 01.2024
Medical Secretary II
University Of Maryland Medical System
10.2017 - 05.2021
Patient Registrar
University of Maryland Midtown Campus
05.2015 - 10.2017
Prior Authorization Certified Specialist (PACS)
High School Diploma -
Oakland Mills High
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