Judy Degollado

· Gather patient demographic and financial information in a kind and courteous manner

· Review schedule/pre-registrations/registrations to find potential duplicate medical record numbers

· Validate verification and documentation of insurance eligibility and coverage for expected procedures

· Validate insurance authorizations were obtained from referring physicians and payors when necessary

· Payments received will be receipted and accounted for

· Complete all pre-service work functions on items in the Epic work queues in accordance with defined policies and procedures

· Direct patients to the appropriate departments or physician examinations

· Answer patient and family questions about hospital processes, insurance coverage and billing

· Received and processed all DME requests

· Reviewed chart notes to assess qualifications according to Medicare guidelines

· Analyzed supporting documentation for clinical oxygen and CPAP test findings

· Determined ICD-1O CM codes and allocated appropriate HCPCS codes

· Verified patients’ eligibility and submitted a complete prior authorization request with the appropriate evidence for insurance approval

· Knowledge of insurance guidelines, including HMP/PPO, Medicare and state Medicaid.

· Providing quality customer service in high-volume settings

• Verified patient's insurance eligibility and benefits coverage.
• Communicated with primary care offices and insurance companies to obtain authorization.
• Called the patient to confirm the appointment and prepared paperwork prior to visit to expedite check-in process.
• Engaged with patients to provide critical information.
• Compiled and maintained patient medical records to keep information complete and up-to-date.
• Followed document protocols to safeguard confidentiality of patient records.
• Answered incoming calls, scheduled appointments, and filed medical records.
• Verified patient insurance eligibility and entered patient information into the system.
• Telephoned and interviewed patients and family members to obtain pre-registration information and confirm appointments.
• Answered over 50 telephone calls per day to handle rescheduled, missed, and reassigned visit requests
• Demonstrated exceptional customer service to foster welcoming and professional environment for patients.

• Restocked supplies and placed purchase orders to maintain adequate stock levels.
• Executed record filing system to improve document organization and management.
• Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
• Prepared Physician Certification (PCS) of Medical Necessity for Non-emergency transportation, and requested authorization number (PAN) for TMHP for patient transport to doctor visit.
• Prepared Invoices for Hospice, Private Pay Patients, and Football Games stand-by.
• Managed paper and electronic filing systems by routing various documents, taking messages, and managing incoming and outgoing mail.

• Monitored each patient closely during treatment to check for any adverse reactions or changes in condition and reported emergencies to attending nurses
• Set up and operated dialysis machines for patients receiving treatment for kidney failure
• Provided in-patient care for 12 dialysis patients simultaneously focusing on providing clean, safe, and comfortable treatment environment
• Cleaned and sterilized instruments, equipment, and surfaces
• Monitored patient vital signs, lab results, and other indicators of health
• Cared for patients by providing personal assistance and ambulation
• Utilized medical software to document and track patient progress
• Recorded client data on hemodialysis flow chart
• Performed routine quality control and safety checks on all equipment.
• Cleaned and connected fistulas, grafts to prevent infection.