Fern Savoy
Beaumont,TX
Summary
Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities. Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Overview
16
16
years of professional experience
Work History
Precertification Specialist 111
Texas Digestive Disease Consultants
2019.09 - Current
- Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
- Developed comprehensive knowledge of various insurance plans, policies, and coverage limitations to provide accurate guidance to patients and providers.
- Boosted efficiency within the team by regularly updating coworkers on changes in insurance policies or procedural requirements affecting precertifications.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Nurtured strong professional relationships with insurance representatives, fostering a collaborative atmosphere during negotiations on behalf of patients.
- Expedited treatment commencement by promptly acquiring authorizations for medically necessary services within required timeframes.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Analyzed trends in denials or authorization delays to identify opportunities for improvement within the precertification department.
- Continuously expanded personal knowledge of industry regulations and updates through ongoing professional development, ensuring accurate and up-to-date expertise in the precertification process.
- Minimized claim denials by accurately coding procedures according to CPT guidelines before submission for approval.
- Mitigated potential delays in service delivery through proactive identification of potential roadblocks within the precertification process.
- Improved team productivity with regular training sessions on new software programs and tools utilized in the precertification process.
- Contributed extensively to departmental goals through consistent achievement of individual performance benchmarks related to precertification accuracy and timeliness.
Per-certification
South East Texas Gastroenterology Associates/TDDC
2018.07 - Current
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
Precertification Specialist
Baptist Hospital East
2009.01 - 2018.09
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Improved team productivity with regular training sessions on new software programs and tools utilized in the precertification process.
- Minimized claim denials by accurately coding procedures according to CPT guidelines before submission for approval.
- Continuously expanded personal knowledge of industry regulations and updates through ongoing professional development, ensuring accurate and up-to-date expertise in the precertification process.
- Expedited treatment commencement by promptly acquiring authorizations for medically necessary services within required timeframes.
- Developed comprehensive knowledge of various insurance plans, policies, and coverage limitations to provide accurate guidance to patients and providers.
- Mitigated potential delays in service delivery through proactive identification of potential roadblocks within the precertification process.
- Nurtured strong professional relationships with insurance representatives, fostering a collaborative atmosphere during negotiations on behalf of patients.
- Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
- Increased accuracy of submitted claims through meticulous attention to detail in verifying insurance eligibility and benefits.
Education
High School Diploma -
Sterling High School
Houston, TX05.1996
Skills
- Prior Authorization Knowledge
- Strong Communication Skills
- HIPAA compliance awareness
Timeline
Precertification Specialist 111
Texas Digestive Disease Consultants
2019.09 - Current
Per-certification
South East Texas Gastroenterology Associates/TDDC
2018.07 - Current
Precertification Specialist
Baptist Hospital East
2009.01 - 2018.09
High School Diploma -
Sterling High School
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