Jennifer Scarincio
Prior Authorization Specialist
Las Vegas,NV
Summary
Healthcare professional with a strong background in prior authorizations, insurance eligibility, and surgery scheduling, dedicated to enhancing operational efficiency. Skilled in managing complex schedules and coordinating with medical teams to ensure optimal patient satisfaction. Renowned for fostering collaborative teamwork and demonstrating adaptability in fast-paced healthcare environments. Possesses exceptional organizational and communication skills, consistently contributing to streamlined processes and improved patient care outcomes.
Overview
9
9
years of professional experience
Work History
Prior Authorization & Insurance Specialist
My OBGYN Las Vegas
Las Vegas, NV
10.2025 - Current
- Reviewed prior authorization requests to ensure compliance with policies and guidelines.
- Collaborated with healthcare providers to obtain necessary documentation for approvals.
- Streamlined workflow processes to improve efficiency in handling authorization requests.
- Developed training materials for new hires on prior authorization procedures and systems used.
- Led initiatives to enhance communication between departments regarding authorization protocols.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Provided training to new staff members on the intricacies of various insurance plans and their specific prior authorization requirements.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
- Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Streamlined prior authorization processes by implementing efficient tracking systems.
- Advocated for patients by negotiating with insurance providers to cover necessary treatments not initially authorized.
Surgery Scheduler
Ortho Las Vegas
Las Vegas, NV
11.2024 - 03.2025
- Expertly scheduled various outpatient procedures.
- Scheduled 30+ cases per month.
- Handled urgent requests effectively, prioritizing cases requiring immediate attention while also balancing routine surgery demands appropriately.
- Managed office bookkeeping with insurance billing and patient payments.
- Assisted with medical coding and billing tasks.
- Boosted efficiency of surgery preparation tasks, ensuring all necessary documentation was completed and filed.
- Reduced scheduling errors significantly, meticulously verifying details with surgeons and anesthesiologists.
- Streamlined insurance verification processes, ensuring all procedures were approved and properly documented.
- Enhanced patient education on pre- and post-surgery care, contributing to better recovery outcomes.
- Coordinated with multiple departments to ensure smooth operation on surgery days, reducing patient wait times.
- Contributed to overall clinic success with proactive identification of areas for process improvement in scheduling systems.
Surgery Scheduler
Total Sports Medicine & Orthopedics
Las Vegas, NV
09.2021 - 11.2024
- Handled urgent requests effectively, prioritizing cases requiring immediate attention while also balancing routine surgery demands appropriately.
- Arranged pre-operative and post-operative appointments for surgical patients.
- Handled 45+ cases per month. Closed 95% outpatient procedures per month.
- Verified insurance coverage and obtained pre-authorizations.
- Maintained strict confidentiality in handling sensitive patient information, adhering to HIPAA guidelines and clinic policies.
- Acted as a liaison between patients, insurance carriers, and the surgical team to secure necessary authorizations for timely procedures.
- Coordinated surgical team schedules for seamless procedure planning and execution.
- Streamlined operational efficiencies by collaborating with surgeons, anesthesiologists, and nursing staff to coordinate timely surgeries.
- Facilitated communication between patients and medical staff, improving clarity and reducing anxiety.
- Managed office bookkeeping with insurance billing and patient payments.
Office Medical Biller
Total Sports Medicine & Orthopedics
Las Vegas, NV
07.2017 - 09.2021
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Reduced claim denials by meticulously
- Managed incoming calls. Averaged 40+ per week.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Organized filing system for patient records, expediting access to essential documents when needed.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Reduced instances of denied claims, carefully reviewing and rectifying coding errors before submission.
- Enhanced team productivity by organizing regular training on best practices in medical billing and coding.
Front Desk Coordinator
Total Sports Medicine & Orthopedics
Las Vegas, NV
07.2017 - 09.2021
- Ensured accurate billing by carefully reviewing invoices before issuing them to clients or submitting payment requests internally.
- Managed 50-60 phone calls per day.
- Balanced daily cash drawer reconciliations, ensuring accurate financial recordkeeping.
- Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
- Maintained strict confidentiality when handling sensitive client information in accordance with company policies.
- Successfully managed challenging situations involving guest complaints or issues by employing excellent problem-solving skills.
- Scheduled appointments in computer system.
- Maintained a clean, organized reception area, creating a welcoming atmosphere for clients and visitors.
- Kept accounts in balance and ran daily reports to verify totals.
- Trained all staff on front desk procedures and policies.
- Maintained office supplies by taking inventory and submitted orders for low-stock items.
- Provided administrative support to management staff, contributing to overall office productivity.
- Handled high volumes of incoming calls, directing callers to appropriate departments for prompt assistance.
Education
Medical Billing & Coding - Health Administration
Kaplan University Online
Davenport, IA01.2017
Skills
- Client support
- Streamlined guest arrival and departure procedures
- Analytical problem-solving
- Schedule management
- Clear and concise documentation abilities
- Insurance expertise
- Documentation skills
- Billing management
Timeline
Prior Authorization & Insurance Specialist
My OBGYN Las Vegas
10.2025 - Current
Surgery Scheduler
Ortho Las Vegas
11.2024 - 03.2025
Surgery Scheduler
Total Sports Medicine & Orthopedics
09.2021 - 11.2024
Office Medical Biller
Total Sports Medicine & Orthopedics
07.2017 - 09.2021
Front Desk Coordinator
Total Sports Medicine & Orthopedics
07.2017 - 09.2021
Medical Billing & Coding - Health Administration
Kaplan University Online