Summary
Overview
Work History
Education
Skills
Timeline
Generic

Brenda Lincoln

Decatur,GA

Summary

Detail-oriented Radiology Prior Authorization Specialist with over 15 years of experience in healthcare administration. Proven track record of securing prior authorizations for radiology procedures, ensuring accuracy and compliance with insurance guidelines. Skilled in navigating insurance systems, communicating effectively with patients and providers, and meeting productivity targets. Seeking to leverage expertise to support a healthcare organization in facilitating timely and accurate prior authorizations for radiology services.

Overview

16
16
years of professional experience

Work History

ASR- APPT SCHEDULING REPRESENTATTIVE

Patriot Strategies
09.2022 - 02.2024
  • Scheduled appointments regionally on behalf of the Dept. of Veteran of Affairs.
  • Completed daily referral requests in AWF work queue.
  • Received incoming calls and outbound calls to veterans and facilities to schedule new and existing patient appointment.
  • Processed referrals ensuring complete and accurate registration and appropriate clinical data before scheduling new appointments.
  • Electronic faxing and sending medical records to facilities for review.


Prior Authorization Specialist

Phoenix MedCom
01.2022 - 08.2022
  • Monitored HSS referral work queues to determine encounters requiring pre-registration, verification, or authorization, ensuring proper billing.
  • Met daily and weekly productivity goals consistently by working encounters according to assignment.
  • Evaluated physician referral and authorization requirements, ensuring compliance prior to procedure date.
  • Reviewed clinical documentation for CPT/diagnosis code information, supporting authorization/precertification according to payer guidelines.
  • Accurately monitored, reviewed, and processed authorizations, validating requests for accuracy, timeliness, and compliance with insurance guidelines. Documented pertinent information and efforts in computer system based on department documentation standards.

Patient Access Representative

T2 Flex Force- Remote
08.2021 - 01.2022

Responsible for scheduling and interacting with patients via inbound calls. Perform a range of clinical administrative duties including registration, insurance verification, scheduling, documentation review, prior authorization request and other tasks directed by team lead.

  • Handled 60-80 calls per day to address patient inquiries and concerns, scheduling and updating patient information.
  • Performed duties in accordance to HIPAA policies and regulatory guidelines to promote safe working environment and sharing of patient health information.


CSR Tier 1- Contract

Kforce Global Solutions- Remote
05.2021 - 07.2021
  • Handled average of 50- 60 incoming calls from patients regarding appointments, inquiries, and general information about healthcare services.
  • Provided courteous and professional assistance to patients, addressing their questions, concerns, and scheduling needs.
  • Maintain accurate and up-to-date patient records in electronic health record (EHR) systems, documenting all interactions and information accurately and confidentially.

Medical Receptionist- Contract

NexGen Medical Center
10.2019 - 02.2020
  • Scheduled and confirmed patient appointments for diagnostic, treatment and consultation for non surgical treatment options related to orthopedic injuries due to motor vehicle accidents.
  • Maintain accurate and up-to-date medical records for patients involved in motor vehicle accidents, including documentation of injuries, treatments, diagnostic tests, and follow-up care.
  • Coordinate communication between healthcare providers, insurance companies, legal representatives, and others involved in the patient's care and recovery process.

EVS Technician

Emory St Joseph Hospital
02.2019 - 06.2019
  • Reviewed daily schedules to plan out cleaning routines and gather needed supplies for Emergency room and Critical Care unit; prevented spread of infections by sanitizing surfaces, furniture and equipment in patient rooms, staff lounges, public and unit bathrooms.
  • Reduced risk of infection by properly disposing of hazardous materials and maintaining strict hygiene protocols.

EVS Housekeeper/ Patient Financial Advisor

New York Presbyterian Hospital- CUMC
01.2008 - 08.2014
  • Clean and sanitize patient rooms, including beds, furniture, surfaces, and medical equipment, following established protocols and infection control guidelines.
  • Dispose of waste and hazardous materials properly, including biohazardous waste, sharps, and soiled linens.
  • Coordinate and schedule patient admissions, transfers, and discharges in collaboration with healthcare providers, nursing staff, and other departments.
  • Maintain and update patient records, including medical histories, consent forms, and other relevant documentation, in electronic health record (EHR) systems.
  • Assist with discharge planning processes by coordinating follow-up appointments, arranging transportation services, and providing patients with discharge instructions and educational materials.
  • Collaborate with case managers, social workers, and community resources to ensure a smooth transition from hospital to home or other care settings.


Education

Medical Office Administrator Certified (MOAC)

Management And Strategy Institute
Downingtown, PA
07.2021

Certification of Completion: #292658

HIPAA For Business Associates
Online
06.2021

Associate of Applied Science - Health Administration

ASA College
Brooklyn, NY

High School Diploma -

Satellite Academy High School
New York, NY
06.1998

Skills

  • Proficient in obtaining prior authorizations for radiology procedures via phone or payor portals
  • Strong understanding of healthcare and insurance terminology
  • Excellent communication skills, both verbal and written
  • Ability to navigate insurance systems and online portals effectively
  • Detail-oriented with strong organizational skills
  • Experience working in a fast-paced healthcare environment
  • Ability to work independently and as part of a team
  • Proficient in Microsoft Office and electronic health record (EHR) systems such as Epic

Timeline

ASR- APPT SCHEDULING REPRESENTATTIVE

Patriot Strategies
09.2022 - 02.2024

Prior Authorization Specialist

Phoenix MedCom
01.2022 - 08.2022

Patient Access Representative

T2 Flex Force- Remote
08.2021 - 01.2022

CSR Tier 1- Contract

Kforce Global Solutions- Remote
05.2021 - 07.2021

Medical Receptionist- Contract

NexGen Medical Center
10.2019 - 02.2020

EVS Technician

Emory St Joseph Hospital
02.2019 - 06.2019

EVS Housekeeper/ Patient Financial Advisor

New York Presbyterian Hospital- CUMC
01.2008 - 08.2014

Medical Office Administrator Certified (MOAC)

Management And Strategy Institute

Certification of Completion: #292658

HIPAA For Business Associates

Associate of Applied Science - Health Administration

ASA College

High School Diploma -

Satellite Academy High School
Brenda Lincoln