Authorization Specialist, Lead Insurance Verifier, Financial Counselor, Medical Billing Specialist and Floor Coordinator with excellent communication skills demonstrated by 22 years of experience in the healthcare field.
Overview
28
28
years of professional experience
Work History
AUTHORIZATION SPECIALIST/R1
Ascension Seton Cedar Park
Cedar Park, Texas
01.2021 - Current
Executed payor authorizations and insurance benefit verifications, ensuring compliance for services rendered.
Assisted clients with accurate eligibility form, application and document completion.
Rectified discrepancies in client applications, confirming eligibility and facilitating timely service delivery.
Devised strategies to streamline eligibility verification processes, improving overall workflow.
Created databases to track and automate eligibility application processes, improving accuracy and streamlining workflows.
Processed and certified documents for accuracy and compliance with government regulations.
Trained staff on current eligibility requirements and policies.
Communicated with people from various cultures and backgrounds on the application process.
Developed fact-checking and research skills through comprehensive review of various programs and options.
TRAINER
INSURANCE VERIFIER, INSURANCE VERIFIER, NORTHWEST HEALTH PORTER HOSPITAL
01.2009 - 01.2021
Develop and implement new policies and procedures
Led process improvement initiatives that enhanced retention rates and customer satisfaction
Recommended changes to existing methods, enhancing accuracy and responsiveness in customer service
Resolved customer issues by actively listening and providing effective solutions.
Clarified expectations with team members to improve collaboration
Work to ensure that patients' health care benefits cover required procedures
Work with patients to educate them on their benefits and the cost of tests or procedures
Provide procedure codes to insurance companies and physician offices along with the cost of the tests or procedures
Cross-trained staff to ensure support during high-demand periods
insurance representatives when needed.
FINANCIAL COUNSELOR
PORTER HOSPITAL
01.2005 - 01.2009
Monitored status of assigned monthly accounts to ensure timely follow-up and resolution of outstanding balances
Reviewed and analyzed self-pay accounts to identify discrepancies, facilitating optimized payment solutions for patients
Documented transaction details on patient accounts to maintain accurate financial records and facilitate communication
Perform appropriate maintenance to accounts, which would include preparation of account combinations, payment
arrangements, payroll deductions forms, and relevant changes to financial class and representative codes
Perform appropriate maintenance to accounts, which would include preparation of account combinations, payment
arrangements, payroll deductions forms, and relevant changes to financial class and representative codes
Documented detailed transactions for each patient account
Entered financial transactions and initiated collection processes for accounts
UNIT COORDINATOR
LAPORTE HOSPITAL PSYCHIATRIC UNIT
01.1999 - 01.2001
Led safety and quality initiatives under direction of department floor nurse, coordinated staff scheduling, and streamlined workflow processes.
Make daily rounds to ensure patient care andsafety for all on the unit
Conducted daily rounds to monitor patient care and safety on the unit. to ensure patient care and
safety for all on the unit
Maintained a safe and clean environment through regular inspections and organization of facilities.
Adapted to various situations to effectively complete work and support team objectives.
Education
Certificate -
Medical Billing
Valparaiso, IN
08.1993 - 09.1993
LPN Certificate -
Horizon Career College
Merrillville, IN
High School Diploma -
Portage High School
Portage, IN
Skills
Eligibility Determinations
Authorizations Knowledge
Healthcare billing expertise
Benefits Guidelines
Referral management
Patient Scheduling
Patient Education
HIPAA Regulations
Clinic Administration
Data Entry
Referral Tracking
Medical Consultation
Critical Thinking
Client Relationship Management
Staff training
Conflict Resolution
Active Listening and Communication
Information Assistance
Timeline
AUTHORIZATION SPECIALIST/R1
Ascension Seton Cedar Park
01.2021 - Current
TRAINER
INSURANCE VERIFIER, INSURANCE VERIFIER, NORTHWEST HEALTH PORTER HOSPITAL
Insurance Verification and Authorization Specialis at First Coast Heart And VascularInsurance Verification and Authorization Specialis at First Coast Heart And Vascular