Heather Pridgen
Snow Hill,NC
Summary
Organized administrative professional with hands-on experience supporting areas such as virtual primary care patient referrals. Collaborative team player with strong communication, decision-making, and time management abilities. Skilled Senior Referral Coordinator with five years of experience managing referrals for numerous primary care providers. Reputation for skillfully communicating with stressed patients and ensuring full satisfaction. Thrive in a high-volume virtual primary care company.
Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.
Overview
15
15
years of professional experience
Work History
Senior Referral Coordinator
Doctor On Demand by Included Health
Snow Hill, NC
03.2020 - Current
- Scheduled patients according to availability, urgency, and insurance authorization guidelines.
- Managed up to 15 patient referrals daily through multi-line telephone system.
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
- Answered questions and resolved concerns raised by both patients and specialists.
- Reviewed demographic, clinical and insurance information before sending to referred specialists.
- Reviewed referral details and expectations with providers and patients and requested new referrals when necessary.
- Identified and resolved inconsistencies in patient responses by means of appropriate questioning or explanation.
- Provided direct service and support by handling referrals for advocacy issues or resolving complaints.
- Tracked referral request progress and resolved issues to maintain smooth processing.
- Assisted patients by answering questions and providing information regarding referrals.
- Entered confidential patient information and updated electronic records in database.
- Managed and obtained insurance authorizations for patient referrals from physicians.
- Obtained PA for services such as diagnostic imaging.
- Gathered and verified insurance requirements to meet payer requirements.
- Collected required signatures to initiate referral process.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Collaborated with clinical and administrative staff to meet patient needs.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Scheduled and confirmed patient appointments and consultations.
- Routed laboratory or diagnostic results to appropriate staff.
- Monitored patient progress throughout the referral process.
- Performed data entry related to referrals into electronic health record systems.
- Coordinated with external agencies to ensure timely processing of referrals.
- Communicated with patients with compassion while keeping medical information private.
- Provided feedback on relevant referral trends, issues, and best practices.
- Provided exceptional customer service, addressing patient inquiries and concerns with empathy and professionalism.
- Ensured compliance with applicable laws and regulations regarding referrals.
- Collaborated with internal departments to ensure smooth transitions for referred patients.
- Maintained accurate records of all referrals, including contact information and follow-up activities.
- Participated in training and professional development opportunities to stay current with best practices in referral coordination.
- Participated in regular meetings to discuss referral strategies, network expansion, and program performance metrics.
- Explained policies, procedures and services to patients.
- Provided excellent customer service to both internal and external customers.
- Reviewed medical records to determine if additional services are needed prior to making a referral.
- Ensured compliance with HIPAA regulations when handling patient information.
- Assisted in training new employees on the organization's policies for making referrals.
- Implemented process improvements to enhance efficiency and effectiveness of the referral coordination system.
- Assisted in the development of referral processes and procedures.
- Resolved issues arising during the referral process, including insurance denials and appointment scheduling conflicts.
- Communicated regularly with patients regarding their care plans following a referral.
- Collaborated closely with team members to achieve project objectives and meet deadlines.
- Worked with cross-functional teams to achieve goals.
Office Manager/Senior Payroll Specialist
Wade Dental Lab, LLC
Snow Hill, NC
07.2015 - 05.2022
- Reviewed orders, instructions and prescriptions written by Dentists to complete work accurately.
- Generated invoices, processed payments and prepared deposits and part of financial operations oversight.
- Kept operations running smoothly and solved diverse problems by coordinating with customers, management and internal departments.
- Ensured proper entry and processing of patient prescriptions in company system.
- Set and managed case information using Lab Annex.
- Monitored payments due from clients and promptly contacted clients with past due payments.
- Handled scheduling and managed timely and effective allocation of resources and calendars.
- Managed office budget to handle inventory, postage and vendor services.
- Ordered supplies and equipment to maintain adequate inventory levels.
- Organized team activities to build camaraderie and foster pleasant workplace culture.
- Assisted in recruiting, onboarding and training new employees.
- Processed payroll accurately ensuring all employees were paid on time.
- Monitored inventory levels and placed orders when needed.
- Ensured compliance with applicable laws regarding employment practices.
- Resolved customer inquiries in a timely manner while maintaining positive relationships with clients.
- Used judgment and initiative in handling confidential matters and requests.
- Managed, scheduled and coordinated office functions and activities for employees.
- Performed general bookkeeping duties such as reconciling bank statements and creating journal entries.
- Tracked invoices and payments to ensure accuracy of accounts receivable and payable information.
- Reviewed files and records to obtain information and respond to requests.
- Responded to customer inquiries via phone or email in a professional manner.
- Answered phone calls, responded to emails, routed mail and coordinated courier services.
- Implemented and maintained company protocols to facilitate smooth daily activities.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Maintained filing system for records, correspondence and other documents.
Assistant Food Service Associate
Mt. Calvary Christian Academy
Hookerton, NC
08.2018 - 05.2019
- Performed all work to top standards, proving best service for students, employees and school visitors.
- Maintained tools, equipment, and surfaces in clean, neat and working order.
- Utilized safe and efficient methods for operating equipment.
- Upheld correct procedures for preparing foods and storing leftovers.
- Prepared food according to recipe instructions to manage regular school meals.
- Followed guidelines for safe serving, appropriate temperatures, and proper presentation.
- Monitored use of condiments, utensils, and beverages and restocked as needed.
- Executed cash transactions quickly and accurately.
- Rotated inventory to reduce waste and optimize freshness.
- Prepared variety of foods according to exact instructions and recipe specifications.
- Maintained professional demeanor during interactions with customers and co-workers.
- Wiped down tables and removed trash and dirty plates to provide clean, welcoming dining environment.
- Inspected dining areas regularly to ensure they met health code requirements.
- Gathered ingredients and cleaned and cut food items to prep recipes.
- Cleaned and sanitized work areas, equipment, utensils, dishes, and silverware.
- Operated cash register to process payments from customers.
- Stored perishable food items in freezer or refrigerator to protect from spoilage.
- Monitored temperatures of prepared food and cold-storage areas.
- Cleaned kitchen surfaces, utensils and equipment after each shift.
- Collaborated with team to deliver timely service of items.
- Followed food safety regulations pertaining to sanitation, food handling and storage.
- Performed variety of duties related to food service.
Home Childcare Provider
Self Employed
Snow Hill, NC
01.2010 - 06.2015
- Communicated with parents or guardians about daily activities, behaviors and upcoming events.
- Assisted children in the development of social, communication, and problem-solving skills.
- Used techniques such as positive reinforcement and behavior modeling to instill discipline in children.
- Provided care to groups of up to three children between the ages of newborn and three years old.
- Established and maintained safe, supportive and welcoming environments for children of all backgrounds.
- Balanced schedules to promote optimal rest, play and educational periods.
- Plan and prepare meals, snacks, activities and outings appropriate to the age of the children.
- Administer medications according to parental instructions if needed.
- Supported children's emotional and social development, encouraging understanding of others and positive self-concepts.
- Employed positive guidance strategies to encourage children and improve behavior.
Education
Bachelor of Arts - Elementary Education
Patriot Bible University
Del Norte, CO03.2011
High School Diploma -
Mt. Calvary Christian Academy
Hookerton, NC03.2003
Skills
- Patient Referral needs assessment
- Insurance precertification processes
- Patient scheduling
- Accurate documentation
- Multitasking
- Organizational skills
- Friendly, positive attitude
- Electronic health records
- Authorization management
- Regulatory compliance
- Data entry
- Customer service
- Process improvement
- Conflict resolution
- Communication skills
- Team collaboration
- Attention to detail
- Empathetic communication
- Project oversight
- Problem-solving abilities
- Reliability
- Medical scheduling
Timeline
Senior Referral Coordinator
Doctor On Demand by Included Health
03.2020 - Current
Assistant Food Service Associate
Mt. Calvary Christian Academy
08.2018 - 05.2019
Office Manager/Senior Payroll Specialist
Wade Dental Lab, LLC
07.2015 - 05.2022
Home Childcare Provider
Self Employed
01.2010 - 06.2015
Bachelor of Arts - Elementary Education
Patriot Bible University
High School Diploma -
Mt. Calvary Christian Academy