JANELLE DALEY
Montclair,NJ
Summary
Forward-thinking professional bringing 3 years of experience working for fast-paced physician practice. Exceptional success driving financial improvements and revenue increases for large specialty practices.
Overview
9
9
years of professional experience
Work History
Practice Supervisor
RWJBarnabas Health
01.2021 - Current
- Manage daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Manage daily operations for a busy medical practice, ensuring efficient workflow and timely care delivery.
- Implemented new appointment scheduling system, reducing patient wait times and improving overall satisfaction.
- Optimized office space utilization by redesigning layout configurations, creating a more welcoming environment for patients and staff alike.
- Improved operational efficiency through regular review of processes, identifying areas for improvement and implementing necessary changes.
- Led the selection process for new employees, identifying qualified candidates who contributed positively to the practice culture.
- Enhanced team collaboration by implementing effective communication strategies within the practice environment.
- Order all office supplies and maintain inventory levels.
- Addressed and remedied all patient or team member issues.
- Supervises a team of 4 office personnel.
- Developed close working relationships with front office and back office staff.
- Boosted staff morale by offering constructive feedback and specific direction.
- Oversaw accounting, budgeting, and financial reporting.
- Developed and implemented strategies to improve patient access, satisfaction and care quality.
- Provided outstanding support to entire staff which helped improve process flow and boosted efficiency.
- Trained newly hired team members on office procedures and computer system.
- Established and maintained effective communication with staff, physicians to promote high quality patient care.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
Scheduler/ Referral Authorization Specialist
RWJ Barnabas Health
07.2018 - 01.2021
- Greets patients and visitors in a courteous and friendly manner
- Monitors office's task list of all requested referrals and authorizations ordered by physicians
- Knowledgeable of ICD 10 and CPT coding
- Identifies the referral and authorization requirements of the patient's insurance plans by using on-line resources and speaking directly with the insurance companies
- Verifies insurance eligibility and benefits, and updates the patient's insurance information as needed
- Demonstrate knowledge of insurance carrier guidelines, clinical policies and state guidelines pertaining to referrals and prior authorizations
- Completes referrals and prior authorizations in a timely manner according to office and physician workflow and guidelines
- Demonstrates system knowledge, documents and manages referrals and prior authorizations, resolves eligibility and authorizations holds and tasks within the user accessibility
- Schedules all patient's for testing and specialty appointments once referrals and authorizations obtained
- Perform appointment scheduling and registration for patients as well as updating demographic information
- Maintained high levels of customer satisfaction through diligent scheduling coordination, ensuring all deliverables were met within agreed time frames.
- Completed daily logs for management review.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Evaluated trends in authorization denials to identify areas for improvement in both internal processes and external communications with payers.
Patient Service Representative
Summit Medical Group/Family Medicine
10.2016 - 06.2018
- Greet patient visitors and non-visitors in a warm and friendly manner
- Responsible for completing all documents required for insurance and patient billing
- Knowledgeable about the Registration process including compliance regulations governing HIPAA and Patient Privacy Act and Confidentiality guidelines
- Verify/ensure insurance information is accurate and detailed
- Collect co-payments in accordance with patients' insurance and financial policies
- Review patient profile, updating information in database as needed
- Responsible for answering all incoming calls professionally and courteously.
- Transfer calls to appropriate area or person and announce calls, as appropriate
- Scheduling all incoming calls from patients that need appointment
- Contact patients that need follow up appointments
- Process referrals
Patient Service Representative
Summit Medical Group/Central Registration
08.2015 - 10.2016
- Greet patient visitors and non-visitors in a warm and friendly manner
- Responsible for completing all documents required for insurance and patient billing
- Knowledgeable about Registration process including compliance regulations governing HIPAA and Patient Privacy Act and Confidentiality guidelines
- Ensure insurance information is accurate and detailed
- Collect co payments in accordance with patients' insurance and financial policies
- Daily close out of all payments collected within business day
- Review patient profile, updating information in database as needed
- Responsible for answering all incoming calls professionally and courteously.
- Transfer calls to the appropriate area or person and announce calls, as appropriate
- Scheduling all incoming calls from patients that need an appointment with the facility.
- Print and mail recall letter to patients that need follow up appointment(s)
- Mail New Patient Packets to patients that have up-coming appointments
- Print out No Show letters and mail to patients and referring physicians
- Confirm all appointments.
Education
Master's of Healthcare Administration -
Columbia Southern University
Orange Beach, AL11.2023
Bachelor of Public Administration -
Kean University
Union, NJ05.2012
High School Diploma -
Montclair High School
Montclair, NJJune 2007
Skills
- Training and mentoring
- Schedule Management
- Workflow Management
- Continuous Improvement
- New Hire Training
- Practice Management
- Performance Metrics
- Supplies Ordering
- Problem-Solving
- Excellent Communication
- Organizational Skills
- HIPAA Guidelines
Accomplishments
- National Society of Leadership and Success-Online Chapter
- Omega Nu Lambada National Honor Society-Online Chapter
- Supervised team of 4 staff members.
Timeline
Practice Supervisor
RWJBarnabas Health
01.2021 - Current
Scheduler/ Referral Authorization Specialist
RWJ Barnabas Health
07.2018 - 01.2021
Patient Service Representative
Summit Medical Group/Family Medicine
10.2016 - 06.2018
Patient Service Representative
Summit Medical Group/Central Registration
08.2015 - 10.2016
Master's of Healthcare Administration -
Columbia Southern University
Bachelor of Public Administration -
Kean University
High School Diploma -
Montclair High School