Christina M Duran

• Reviewed applications for different aid programs and determined which qualification criteria for individuals.
• Documented all communication with applicants and inputted information into system using [Software].
• Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
• Scheduled appointments with applicants to gather information and explain benefits processes.

Enter authorizations. Confirm eligibility, benefits and DOFR . Set appoinments for patients. Review for medicare guidelines for Skilled Nursing Facilities.

• Reached out to insurance carriers to obtain prior authorization for testing and procedures.
• Input all patient data regarding claims and prior authorizations into system accurately.
• Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
• Tracked referral submission during facilitation of prior authorization issuance.

• Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
• Managed large volume of medical claims on daily basis.
• Paid or denied medical claims based upon established claims processing criteria.
• Responded to correspondence from insurance companies.

• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Answered customer telephone calls promptly to avoid on-hold wait times.
• Answered constant flow of customer calls with minimal wait times.
• Offered advice and assistance to customers, paying attention to special needs or wants.