Honey Yeager

• Fostered a welcoming environment for diverse clientele by demonstrating cultural sensitivity when interacting with patrons from different backgrounds.
• Collaborated with team to ensure seamless integration of new employees into the workflow.
• Performed accurate cash handling duties, including opening/closing registers, processing payments, and balancing the till at end of shift; minimizing discrepancies in financial records.
• Promoted a safe and enjoyable atmosphere by monitoring patron behavior for signs of intoxication and taking necessary steps to prevent overconsumption.

• Servicing inbound calls, emails, and/or faxes from our customers. This position will also assist our clinical staff in gathering and collecting all necessary information from our customers in a timely manner to ensure that deadlines are met.
• Fax Triage for Highmark of Pennsylvania-reviewing faxes from providers and facilities for HIPPA and triaging to Highmark for case attachment or setting up PA

Established and maintained correspondence systems to manage information requests and distribution.

• Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
• Remained up-to-date on various benefit plans, medical policies and state-specific clinical guidelines or criteria.
• Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
• Achieved departmental goals and objectives by instituting new processes and standards.

• Processing prior authorization rules based on documented guidelines
• Determining whether a prior authorization is complete with appropriate billing/coding requirements and supporting documents
• Transferring medical data from paper formats into computer files or database systems
• Typing in data provided directly from customers
• Verify data by comparing it to source documents
• Update existing data
• Retrieve data from the database or electronic files as requested
• Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
• Achieved departmental goals and objectives by instituting new processes and standards.
• Knowledge of ICD-10 codes
• Ability to work with minimal supervision and as a team.
• Proficient in EMRs, Microsoft Excel, Microsoft Word, and Google Sheets.
• Medical and Behavioral Health clinical fax triage

• Managing incoming calls or incoming post services claims work.
• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
• Refers cases requiring clinical review to a Nurse reviewer.
• Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.
• Responds to telephone and written inquiries from clients, providers and in-house departments.
• Conducts clinical screening process.
• Authorizes initial set of sessions to provider.
• Checks benefits for facility-based treatment.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.