Efficient Authorization Specialist with comprehensive knowledge of medical insurance policies, coding and procedures. Demonstrated ability to liaise effectively between patients, healthcare providers, and insurance companies for smooth transactions. Strengths include strong problem-solving skills, thoroughness in documentation and a keen eye for identifying inconsistencies. Proven impact in previous roles includes streamlined authorization processes, improved patient satisfaction rates, and reduced claim denials.
Ensure accurate benefit information is entered to reduce insurance rejections and improve processing
Aim to maintain quality while providing an empathetic and supportive experience to patients, radiologists, and physician offices
Complies with the Documentation Guidelines regarding the status of patient benefits and/or authorizations
Discuss benefits and exam coverage issues with patients and/or referring doctors
Inspecting workflow while communicating issues and recording inspection results by completing reports, summarizing re-works/errors by inputting data into quality database
Patient Access - Authorization & Revenue Cycle Lead
Banner Imaging
Mesa, AZ
08.2021 - 06.2022
Lead, develop, and performance managed a group of new hires and experienced team members while monitoring engagement and retention
Lead select special projects related to improving processes to increase efficiency and team outcomes
Handle important accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved
Identify the root cause of claim exceptions, resolve, and/or escalate issues as appropriate for prompt and effective resolution
Patient Access - Senior Authorization Representative and Trainer
Banner Imaging
Mesa, AZ
02.2020 - 08.2021
Responsible for virtual instructor-led new hire training courses, new processes, and procedure courses for existing associates as well as one-on-one training, when needed
Provide clear and direct guidance to teammates on questions and expectations
Creating and implementing new process training, workflow development and training, communicating further information, and workflow changes
Provide coaching and feedback during and after training programs as well as throughout the initial 90 and 120-day review period
Financial Clearance Coordinator
Asante Rogue Regional Medical Center
Medford, OR
05.2019 - 10.2019
Identify payer requirements and any additional information required for processed Approval Requests for upcoming surgeries/radiology procedures for all three Asante facilities in Medford
Provide ongoing financial education and assistance to our patients throughout the continuum of their care, as an educator, advocate, and liaison
Perform verification of benefits, such as charge estimates with adequate supporting documentation for scheduled and unscheduled surgery and radiology procedures
Communicate coverage issues to the care coordination/outpatient center clinical staff; work with patients and staff to resolve issues