JOCELYN Jones

• Performed pre-registration functions such as verifying demographic information, obtaining authorizations, and collecting deposits and co-payments.
• Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
• Processed patient responsibility estimate determined by insurance at pre-registration.
• Verified demographics and insurance information to register patients in computer system.
• Addressed patient inquiries and concerns, resolving issues in a timely and empathetic manner.
• Reviewed eligibility responses to assess patient benefit level and prepare estimates.
• Counselled patients on potential financial liabilities and payment requirements.
• Processed insurance verifications and authorizations to ensure coverage of services.
• Maintained confidentiality of patient information in compliance with HIPAA regulations.

• Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation.
• Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
• Facilitated communication between providers, payers and health plans regarding prior authorization processes.
• Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
• Proofread documents carefully to check accuracy and completeness of all paperwork.
• Coordinated with healthcare providers to gather necessary patient information for prior authorization requests.

Responsible for the education and servicing of assigned provider groups regarding all aspects of the Plan and its subsidiaries.

Responsible for assisting in the development of policy, procedures and educational materials for use with all Provider Programs and for the development of benchmarks to measure performance against the Plan’s goals.

Establishes and maintains effective relationships with key physicians and office staff of contracted medical delivery entities (i.e. provider offices, specialists, etc.).

Responsible for contracting of PCP’s, Specialists, and Ancillary providers in their defined servicing area.

Responsible for claims research and resolution. All duties are to be carried out in collaboration with the contracting staff and other key senior staff as appropriate.

• Performed preliminary physical tests to accurately record results in patient history summary.
• Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
• Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
• Interviewed patients to verify information, record medical history and confirm purpose of visit.
• Organized charts, documents and supplies to maintain team productivity.
• Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.

• Contacted pharmacies to submit and refill patients' prescriptions.
• Scheduled appointments for patients via phone and in person.
• Educated patients about medications, procedures and physician's instructions.
• Led patients to exam rooms, answered general questions and prepared patients for physician by explaining process.
• Collected forms, copied insurance cards and coordinated patient information for billing and insurance processing.
• Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analyses.
• Performed preliminary physical tests, such as taking blood pressure, weight and temperature, accurately recording results in patient history summary.