Carly Eckert
Jacksonville,FL
Summary
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
9
9
years of professional experience
Work History
Precertification Specialist
Borland Groover Clinic
05.2015 - Current
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- 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.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Prepared and processed patient referrals and transfer requests.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
Education
Bachelor of Science - Health Science
University of North Florida
Jacksonville, FL05.2007
Skills
- Effective communication skills
- Patient Interviews
- Database Administration
- Electronic Recordkeeping
- Strong Communication Skills
- Benefits Administration
- Documentation Review
- Telephone Etiquette
- Insurance Verification
- Patient Referral
- Medical Records Verification
- Data Entry
- Referral Verification
- Patient Eligibility Requirements
Timeline
Precertification Specialist
Borland Groover Clinic
05.2015 - Current
Bachelor of Science - Health Science
University of North Florida
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