ELIZABETH CROSBY
Wilmington,DE
Summary
I have worked in healthcare for 20 years in a variety of positions which has given me a broad experience and skills. I love working with people. I have a proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Authorization Specialist Lead
Center For Interventional Pain And Spine
02.2022 - Current
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Assist other auth specialists with workload or any issues/questions that arise.
Senoir Authorization Specialist
Nemours Children's Hospital
01.2016 - 02.2022
- Responsible for obtaining and processing elective, urgent and emergent authorizations for surgical and non-surgical admissions, elective transport and Day Medicine appointments
- Communicate with insurance companies to certify that procedure/admission is necessary and obtain benefits
- Contact families to explain benefits and what their responsibility will be
- Collect co-pays and deductibles
- Work closely with the Utilization Review Nurses to ensure the admission is covered and the claim is paid
- Review authorizations to ensure that all codes match the claim
- Process Paths letters and obtain authorizations for the new insurance
- Support the authorization team both at the hospital and Wells Fargo Tower
- Coordinate lunch schedules of the staff at the hospital (at one time)
- Audit elective/ED team's authorizations
- Interview new applicants for the Authorization Department.
Authorization Specialist II
A. I. duPont Hospital for Children
01.2010 - 01.2016
- Obtaining and processing authorizations for elective orthopedic surgeries
- Communicating with the insurance companies to certify that the surgery is necessary by providing clinical documentation
- Obtaining the patient's benefits
- Communicated with the physicians and their staff regarding any issues obtaining the authorizations
- Communicated with the families to explain their insurance benefits and their responsibility.
Lead PSR Emergency Department
A.I. duPont Hospital for Children
08.2006 - 12.2010
- Greeted patients & families that came in to the emergency department
- Created an encounter in epic so the patient could be triaged
- Registered patient, by obtaining demographic and insurance information
- Collect copays
- Created station assignments for staff each day
- Audit my team's registration work.
Insurance Verification Rep
A.I. duPont Hospital for Children
10.2003 - 08.2006
- Verified benefits and obtained referrals for outpatient office visits in the GI, Allergy, Pulmonology and Cardiac Clinics.
Education
No degree - Business/Social Work
Delaware Technical Community College
High School Diploma -
Delcastle Vo-Tech
Wilmington, DESkills
- Medical terminology
- Insurance Verification
- Medical coding knowledge
- Able to work in a fast pace environment
- Multitasking
Certification
- CRCR 2020
- Authorization Specialist Lead 2/2022 to present
Timeline
Authorization Specialist Lead
Center For Interventional Pain And Spine
02.2022 - Current
Senoir Authorization Specialist
Nemours Children's Hospital
01.2016 - 02.2022
Authorization Specialist II
A. I. duPont Hospital for Children
01.2010 - 01.2016
Lead PSR Emergency Department
A.I. duPont Hospital for Children
08.2006 - 12.2010
Insurance Verification Rep
A.I. duPont Hospital for Children
10.2003 - 08.2006
No degree - Business/Social Work
Delaware Technical Community College
High School Diploma -
Delcastle Vo-Tech
- CRCR 2020
- Authorization Specialist Lead 2/2022 to present
Similar Profiles
Esteban Alonso Fernandez GranadosEsteban Alonso Fernandez Granados
Virtual Assistant Care Manager at Center For Interventional Pain And SpineVirtual Assistant Care Manager at Center For Interventional Pain And Spine
Nicole DresslerNicole Dressler
Patient Service Representative at Reproductive Science Center Of New JerseyPatient Service Representative at Reproductive Science Center Of New Jersey
Jose OvalleJose Ovalle
Medical Data Entry Clerk at Interventional Pain Spine and OrthopedicsMedical Data Entry Clerk at Interventional Pain Spine and Orthopedics