Jenny Woods
Temple,TX
Summary
Auto Insurance Specialist with extensive experience in claims review and coverage verification at Rayus Radiology. Demonstrated success in resolving complex issues and improving customer satisfaction through effective communication and problem-solving skills. Proficient in medical billing and committed to ensuring compliance with insurance protocols while delivering exceptional patient interactions.
Overview
8
8
years of professional experience
Work History
Auto Insurance Specilist
Rayus Radiology
St. Louis Park , MN
04.2023 - Current
- Reviewed denied claims utilizing payer explanations of benefits and online resources.
- Conducted outbound calls to payer provider relations for clarification on denials.
- Resolved routine and complex issues through thorough research.
- Explained coverage options to potential policyholders while addressing questions and concerns.
Emergency Department Registrar
Fairview Southdale Hospital
Edina , MN
03.2022 - 06.2023
- Greeted patients and assessed visit purpose to direct them to appropriate staff.
- Managed front office operations, including scheduling, billing, and customer service tasks.
- Conducted patient interviews to complete intake forms and gather case histories.
- Verified insurance coverage and registered new patients into the system accurately.
- Coordinated with departments to ensure timely delivery of patient care.
- Processed trauma intake registrations efficiently to facilitate prompt medical attention.
- Maintained accurate medical records for departmental patients to support continuity of care.
- Arranged hospital admissions as needed for optimal patient management.
Prior Authorization Specialist
Allina Health
Minneapolis , Mn
10.2021 - 06.2022
- Secured timely approvals for inpatient surgeries by processing prior authorizations.
- Contacted insurance providers to obtain necessary approvals using CPT and diagnosis codes.
- Submitted medical documentation to substantiate authorization requests effectively.
- Processed appeals promptly, adhering to policy guidelines.
- Facilitated communication between providers, payers, and health plans on prior authorization processes.
- Responded to inquiries from providers, patients, and payers about prior authorization status.
Prior Authorization Specialist
Minnesota Oncology
Saint Paul , MN
02.2019 - 09.2021
- Facilitated prior authorizations for new and existing patients requiring cancer treatments.
- Verified insurance coverage and treatment protocol eligibility.
- Ensured compliance of treatment regimens with FDA and NCCN guidelines.
- Faxed and uploaded clinical documentation to secure timely approvals.
- Advised provider offices on coding practices essential for successful claim submission.
- Processed appeals per policy guidelines within designated timelines.
- Coordinated with departments to gather additional information for prior authorization.
- Responded promptly to inquiries from providers, patients, and payers regarding authorization status.
Customer Service Representative
Fairview Health Services
Minneapolis, MN
05.2017 - 04.2019
- Obtained demographic and insurance data for surgeries and MRIs during pre-registration.
- Validated all insurance payors to ensure accurate coverage verification.
- Articulated financial statements to clarify patient charges.
- Established payment plans and assessed patients for financial assistance through Fairview.
- Updated insurance records and efficiently submitted claims.
- Prepared patients for upcoming OB deliveries, verifying insurance details and contact information.
- Addressed billing inquiries to enhance understanding of statements.
- Identified areas of improvement in customer service processes and suggested changes accordingly.
- Developed positive relationships with customers through friendly interactions.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Education
High School Diploma -
Spring Lake Park
Minneota, MN05-1997
Skills
- Claims review and coverage verification
- Policy explanation and prior authorization
- Medical billing and data entry
- Customer service and patient interaction
- Insurance knowledge and auto insurance
References
References available upon request.
Timeline
Auto Insurance Specilist
Rayus Radiology
04.2023 - Current
Emergency Department Registrar
Fairview Southdale Hospital
03.2022 - 06.2023
Prior Authorization Specialist
Allina Health
10.2021 - 06.2022
Prior Authorization Specialist
Minnesota Oncology
02.2019 - 09.2021
Customer Service Representative
Fairview Health Services
05.2017 - 04.2019
High School Diploma -
Spring Lake Park
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