ERICA LANG
Tonawanda,NY
Summary
Detail-oriented Authorization Specialist with over 10 years of experience in the healthcare sector, known for maintaining a monthly audit score above 99% and streamlining outpatient service authorizations. Proficient in medical terminology and data entry, I excel in effective communication and creative problem-solving, ensuring optimal patient and provider interactions in fast-paced environments.
Overview
17
17
years of professional experience
Work History
Authorization Specialist
Fidelis Care / Centene Corporation
Getzville, NY
12.2018 - Current
- Processes DME prior authorizations requests within established time frames
- Accurately enters authorization information into system
- Verify member benefits and eligibility
- Route for clinical review if necessary
- Communicates effectively with members and providers
- Maintains a monthly audit score of above 99% and exceeds hourly production.
Medical Receptionist
UBMD Orthopedics
Amherst, NY
07.2018 - 12.2018
- Welcoming patients
- Confirming patient demographics and insurance details
- Organizing appointments
- Handling phone calls and directing them to the appropriate provider
- Collecting copayments and outstanding balances
- Demonstrating the ability to multitask in a fast-paced medical office
Medical Receptionist
Primary Care of WNY
Kenmore, NY
11.2017 - 07.2018
- Managed patient check-ins by verifying insurance coverage, collecting payments, and updating accounts accordingly.
- Screened incoming phone calls, taking messages or forwarding to appropriate staff.
- Greeted patients immediately upon arrival, providing excellent customer service.
- Verified insurance benefits prior to treatment for accurate billing process.
- Utilized effective problem solving skills to resolve any conflicts that may arise.
Medical Billing Specialist
UBMD Orthopaedics
Amherst, NY
05.2013 - 04.2015
- Utilized electronic billing systems to submit claims to insurance providers in a timely manner.
- Provided excellent customer service when responding to inquiries from patients regarding their bills or other related matters.
- Provided monthly follow-up on No-Fault claims and re-billing of accounts with outstanding balances.
- Efficiently posted payments and adjustments to patient accounts, ensuring accuracy of data entry.
- Responsible for submitting all Workers Comp claims.
Medical Billing Specialist
Excelsior Orthopaedics, LLP
Amherst, NY
07.2008 - 05.2013
- Accurately posts patient and insurance payments to accounts
- Submits claims electronically and by paper with appropriate documentation
- Works monthly aging reports obtaining status of outstanding claims
- Research and resolve EOB rejections, incorrect payments and claim denials
- Prepares appeal information for claim denials and re-submits insurance claims as necessary
- Sends out weekly patient statements and answer any patient inquiries regarding their accounts
- Responsible for ordering necessary supplies needed throughout the department
Education
Cosmetology -
Erie 1 BOCES
Tonawanda, NY06.2006
High school diploma - undefined
Kenmore West High school
Kenmore06.2006
Skills
- Orthopedic billing
- Facility billing
- Medical terminology ICD-10
- CPT codes
- Workers' Comp
- No Fault
- Phone skills
- Interpersonal skills
- Payment posting
- Data Entry
- MS Office
- GE Centricity Billing systems
- Experior Medent
- Creative problem solving
- Multi-tasking
- Fast paced environment
- HIPAA compliance
- Prior authorization processing
- Insurance verification
- Data entry proficiency
- Durable Medical Equipment
- Medical terminology expertise
- Appointment scheduling
- Microsoft office
Timeline
Authorization Specialist
Fidelis Care / Centene Corporation
12.2018 - Current
Medical Receptionist
UBMD Orthopedics
07.2018 - 12.2018
Medical Receptionist
Primary Care of WNY
11.2017 - 07.2018
Medical Billing Specialist
UBMD Orthopaedics
05.2013 - 04.2015
Medical Billing Specialist
Excelsior Orthopaedics, LLP
07.2008 - 05.2013
High school diploma - undefined
Kenmore West High school
Cosmetology -
Erie 1 BOCES