Caitlyn Greulich
Egg Harbor City,NJ
Summary
Dynamic leader with proven expertise in customer service and team leadership, honed at Tomasello Winery and in the healthcare sector. Excels in complex problem-solving and effective communication, significantly enhancing team performance and customer satisfaction. Skilled in documentation and multitasking, consistently achieving goals within tight deadlines.
Overview
16
16
years of professional experience
Work History
Manager
Tomasello Winery
08.2011 - Current
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maintained professional, organized, and safe environment for employees and patrons.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Maximized performance by monitoring daily activities and mentoring team members.
- Cross-trained existing employees to maximize team agility and performance.
- Controlled costs to keep business operating within budget and increase profits.
Prior Authorization Specialist
The Plastic Surgery Center
07.2022 - 10.2022
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
Medical Biller and Coder
Advocare Stafford Orthopedics
01.2014 - 01.2020
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
- Expedited payment processing by promptly addressing any discrepancies or issues raised by insurance carriers.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Collaborated with healthcare providers to ensure accurate documentation, leading to timely reimbursements for services rendered.
- Provided support to administrative staff by ensuring proper handling of sensitive patient data according to HIPAA regulations.
Prior Authorization Specialist
Neurology Institute of South Jersey
04.2009 - 11.2012
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
Education
Associate Of Applied Business - Business Administration
Atlantic Cape Community College
Mays Landing, NJ12.2014
Skills
- Customer service
- Team leadership
- Time management
- Decision-making
- Verbal and written communication
- Complex Problem-solving
- Documentation and reporting
- Cross-functional teamwork
- Business administration
- Clear communication
- Work prioritization
- Computer skills
- Effective communication
- Positive attitude
- Attention to detail
- Multitasking
Timeline
Prior Authorization Specialist
The Plastic Surgery Center
07.2022 - 10.2022
Medical Biller and Coder
Advocare Stafford Orthopedics
01.2014 - 01.2020
Manager
Tomasello Winery
08.2011 - Current
Prior Authorization Specialist
Neurology Institute of South Jersey
04.2009 - 11.2012
Associate Of Applied Business - Business Administration
Atlantic Cape Community College
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