Christine Bisacca-Anchondo

Located on site of Cedars-Sinai Medical Center, I scanned and registered patient laboratory specimens from numerous Cedars-Sinai locations in the Los Angeles area averaging 200-300 specimens per shift. I verified specimen type, physician requisition information including patient demographics, medical insurance, ICD-10 codes and CPT codes matched the specimens received. I verified location the specimen was taken and physician ID to send the results. I also created patient medical records if new to the Epic system. I documented any errors found with specimen itself or incorrect or missing data needed to proceed with processing specimen.

Assisted patient in applying for and changing medical insurance policies, open enrollment, contacted Medicare and Medi-Cal to discuss patients care options during inpatient hospital and Skilled Nursing Facility stays, claim discrepancies, EOB inquiries, insurance coverage, and patient account balances. I also submitted requests for patient transfer to patient preferred skilled nursing facilities, compiled patient medical records, demographics, and documents needed for treatment. I coordinated transportation services for patient. I communicated concerns and requests with patients physicians on behalf of the patient. Provided limited paramedical services such as assistance with medication refills and requests.

Followed-up on pending radiology authorizations and referrals through multiple Utilization management companies. Verified patient eligibility and radiology benefits. Corresponded with physician offices and clinics for denials, modifications, and additional information needed for authorization approval. Forwarded approved authorizations to scheduling departments.

As a HEDIS associate I requested, received, sorted, extracted, filed, and compiled the data for state analysis for 81 healthcare measures from participating providers. I assisted the Quality Management department in collecting the medical records for the Anthem Blue Cross 2018 HEDIS report. I conducted numerous correspondences with physicians offices, hospitals, and medical record storehouses requesting medical records electronically for data analysis adhering to HIPAA privacy regulations. I conducted comprehensive HEDIS data reviews to ensure compliance with performance measures.

I gave a Summary of Benefits and Coverages for medical, vision, and dental policies to members and other medical personnel calling for Insurance benefits verifications. This also included information regarding current deductible, in and out-of-network coverage, out-of-pocket maximums met for the plan year, co-pay information, and not covered services. I assisted members and medical personnel with adjustments to unpaid or incorrectly filed claims. Yearly updates to patient demographics.

Collected patient demographics and insurance information for data entry. Patient registration in Family Medicine, Internal Medicine, Pediatrics, and Urgent Care settings. Verification of patient insurance benefits, appointment scheduling, co-pay collection and end-of-day deposits. Collaborated with other medical offices for in-network patient referrals.