Julia Cabriales

•Conducted pre-authorization and verification of insurance benefits for surgical procedures for ophthalmology, ensuring coverage and minimizing patient financial burden.

• Verified insurance for 450+ patients monthly.

• Liaised with insurance providers to obtain necessary authorizations and resolve any discrepancies in coverage.

•Knowledge of eligibility/authorization medical portals; Availity, United Healthcare, Cigna, Tricare military, Notivasphere,TMHP,Etc.

• Reviewed patient insurance information for accuracy and completeness during the appointment scheduling process.

• Assisted patients in understanding their insurance benefits and financial responsibilities, providing guidance on payment options and plans.

• Worked 3 weeks in advance to provide patients amount due.

• Developed and maintained strong relationships with insurance representatives to facilitate effective communication and issue resolution.

• Coordinate and attend scheduler luncheons, open houses, and other events.

•Schedule 500+ outpatient surgeries monthly, coordinating with physicians and anesthesia teams.

• Ability to understand medical consents, preop orders, HPs and medical clearance’s.

• Developed an ongoing communication plan with physician office schedulers to assess satisfaction and identify opportunities for improvement.

• Set schedules for 29 providers monthly.

• Coordinate schedule with physician time, staffing, procedure complexity, patient age/needs and equipment availability in mind.

• Coordinate with anesthesia group to confirm scheduling coverage.

• Accurately used procedure codes to ensure proper billing.

• Worked with business office manager to determine reimbursement when new procedures scheduled.

• Answer telephone calls, redirect calls accordingly, assist callers with questions or concerns and take messages as needed
• Schedule all new patient appointments and follow up appointments
• Rescheduling of patient appointments as necessitated due to schedule changes
• Enter all patient insurance and demographic information, to include all new patient data and updates to existing patient accounts when scheduling appointments
• Review all patient demographic information on file and identify any information needing
• to be updated by patients coming in for anesthesia
• Scan patient demographics, identifications and medical insurances into the electronic
• medical records (EMR) system
• Mail out new patient forms, packets, and reminders as needed
• Sort and distribute incoming mail
• Calculate fees/charges and collect copayments or allowable, other applicable charges
• Post payments