Christine Hirshberg
Prattville,AL
Summary
Dynamic Precertification Specialist with a proven track record at MedVision LLC, adept at streamlining prior authorization processes and enhancing patient satisfaction. Skilled in electronic health records management and effective communication, I consistently foster strong relationships with insurance representatives, ensuring timely approvals and compliance with HIPAA regulations.
Overview
12
12
years of professional experience
Work History
Precertification Specialist
MedVision LLC
03.2025 - Current
- Processed precertification requests efficiently, ensuring compliance with insurance guidelines.
- Reviewed patient medical records for accuracy and completeness prior to submission.
- Communicated effectively with healthcare providers to gather necessary documentation.
- Utilized electronic health record systems to track and manage precertification statuses.
- Assisted in resolving issues related to denied precertifications through follow-up communication.
- Maintained accurate logs of all precertification activities for reporting purposes.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
Insurance Specialist
Firstsource Solutions
05.2024 - 10.2024
- Processed insurance claims efficiently, ensuring compliance with company policies and regulations.
- Assisted clients in understanding policy details and provided support for claims inquiries.
- Analyzed customer data to identify trends and improve service delivery initiatives.
- Collaborated with cross-functional teams to streamline claim processing procedures.
- Implemented best practices for data entry, enhancing overall accuracy and efficiency.
- Resolved client issues promptly, improving customer satisfaction ratings significantly.
- Maintained accurate documentation of client interactions and transaction records.
- Processed eligibility and benefits verification and authorization requests.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Communicated effectively with members of operations, finance, and clinical departments.
- Acted as subject matter expert, answering internal, and external questions and inquiries.
Patient Care Coordinator
CHI CommonSpirit Health
11.2022 - 11.2023
- Coordinated patient appointments and managed scheduling for optimal resource utilization.
- Communicated with healthcare providers to ensure seamless information exchange regarding patient care.
- Assisted patients in navigating healthcare processes, improving overall satisfaction and access to services.
- Documented patient interactions accurately in electronic health records, ensuring compliance with regulatory standards.
- Collaborated with interdisciplinary teams to develop comprehensive care plans tailored to individual patient needs.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Coordinated with insurance companies for accurate billing and claim processing, reducing errors and financial discrepancies.
- Fostered strong relationships with referral sources for increased network connections, benefiting both the clinic and its patients through expanded resources.
Precertification Specialist
Mobile Infirmary Medical Center
06.2014 - 05.2019
- Adapted quickly to changes in insurance policies and procedures, improving response times.
- Supported team initiatives to streamline workflow processes and enhance service delivery.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Elevated patient satisfaction by offering compassionate guidance and support during the often-stressful precertification process.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Analyzed trends in denials or authorization delays to identify opportunities for improvement within the precertification department.
- Nurtured strong professional relationships with insurance representatives, fostering a collaborative atmosphere during negotiations on behalf of patients.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Continuously expanded personal knowledge of industry regulations and updates through ongoing professional development, ensuring accurate and up-to-date expertise in the precertification process.
Education
High School Diploma -
State of Connecticut
ConnecticutSkills
- Prior authorization
- Strong communication skills
- HIPAA compliance awareness
- Organizational growth
- Insurance verification expertise
- Professionalism and ethics
- Electronic health records management
- Effective communication skills
- Documentation and paperwork
- Microsoft office
- Data entry
- Appointment scheduling
- Documentation and reporting
- Benefits administration
Timeline
Precertification Specialist
MedVision LLC
03.2025 - Current
Insurance Specialist
Firstsource Solutions
05.2024 - 10.2024
Patient Care Coordinator
CHI CommonSpirit Health
11.2022 - 11.2023
Precertification Specialist
Mobile Infirmary Medical Center
06.2014 - 05.2019
High School Diploma -
State of Connecticut