Harshanicka Donald
Lithia,FL
Summary
Proven expertise in streamlining patient care coordination at Moffitt Cancer Center, enhancing patient satisfaction through meticulous scheduling and robust HIPAA compliance. Demonstrates exceptional organizational skills and effective communication, ensuring accurate insurance verification and authorization processing. Achieved significant improvements in operational efficiency and patient service quality.
Overview
8
8
years of professional experience
Work History
Prior Authorization Coordinator
Pasadena Surgery Center
01.2024 - Current
- Reviewed and processed prior authorization requests according to insurance guidelines.
- Determined medical necessity of requested services by reviewing patient records and corresponding with providers as needed.
- Provided customer service support by responding promptly to provider inquiries regarding authorization status or policy information.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Scheduled patient appointments, diagnostic specialty appointments, tests and procedures.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
Medical Appointment Scheduler
MPF Federal
09.2020 - 11.2023
- Informed patients regarding needed medical tests and procedures.
- Reviewed insurance information with patients and processed copays.
- Coordinated with insurance companies to verify coverage and obtain necessary pre-authorizations.
- Managed appointment cancellations and rescheduling, minimizing gaps in physicians' schedules.
- Communicated effectively with patients regarding appointment details, preparation instructions, and follow-up care.
- Maintained patient confidentiality by strictly adhering to HIPAA regulations while handling sensitive personal information.
Patient Care Coordinator
Moffitt Cancer Center
01.2019 - 05.2020
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
- Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
Pre Authorization Specialist
Healthnet Federal Services
06.2016 - 09.2018
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Performed data entry into various computer systems including but not limited to EMRs and CRMs.
- Investigated discrepancies identified during audits of claims submitted for reimbursement by providers.
- Reviewed authorization requests for accuracy and completeness
- Reviewed patient medical records to assist with Scheduling veterans for the most appropriate doctor
Education
Middleton High School
Tampa, FLSkills
- Authorizations
- Benefit Coverage
- HIPAA Compliance
- Strong Organization
- Patient Scheduling
- Insurance Verification
- Medical terminology knowledge
- Effective communication skills
- Understanding of insurance details
- Medicare and Medicaid knowledge
- Billing Procedures
Timeline
Prior Authorization Coordinator
Pasadena Surgery Center
01.2024 - Current
Medical Appointment Scheduler
MPF Federal
09.2020 - 11.2023
Patient Care Coordinator
Moffitt Cancer Center
01.2019 - 05.2020
Pre Authorization Specialist
Healthnet Federal Services
06.2016 - 09.2018
Middleton High School