Danielle Bradley
St. George,Utah
Summary
Highly skilled Authorization and Eligibility Coordinator with a proven track record of successfully managing and processing complex insurance claims. Proficient in utilizing industry-specific software and systems to ensure accurate and timely authorizations. Exceptional attention to detail and strong problem-solving abilities enable me to efficiently navigate through challenges and deliver exceptional results. Adept at collaborating with cross-functional teams and providing excellent customer service to clients.
Overview
20
20
years of professional experience
Work History
Authorization and Eligibility Coordinator
Enhabit Home Health
03.2018 - Current
- Company Overview: formerly Encompass
- Responsible for researching and obtaining patient's insurance benefits prior to their Home Health services
- Review insurance policy to determine coverage and network status
- Obtain authorization for Home Health services
- Manage workflow, distributing visits for patient scheduling as authorized
- Formerly Encompass
Quality Assurance Assistant
Intermountain Healthcare
05.2014 - 02.2018
- Actively listen to patient registration phone calls and review patient accounts ensuring that all federal/state privacy laws and internal guidelines for quality patient care and billing processes are followed
- Identify compliance issues that require follow-up or investigation
- Provide employee training on compliance related topics, policies, or procedures
Compliance
Intermountain Healthcare
12.2012 - 05.2014
- Respond to patient information requests from third parties outside of Intermountain HealthCare (i.e
- Ambulance companies, physician offices)
- Research and update patient demographic information ensuring it was accurate, compiled this information, and returned it to the sender under strict privacy settings safeguarding patient information from unlawful release
Insurance Verification/Authorization Representative
Intermountain Healthcare
08.2007 - 12.2012
- Responsible for researching and obtaining patient's insurance benefits prior to their radiology scan or surgical procedure
- Review insurance policy to determine coverage
- Worked with physician offices to obtain authorization for outpatient/inpatient surgical procedures and radiological scans, this function included proficiency in medical coding
Registrar
Intermountain Healthcare
10.2004 - 08.2007
- Process patient admission or discharge documents
- Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer
- Identify, compile, abstract, and code patient data, using standard classification systems
Education
SOUTHERN VIRGINIA UNIVERSITY
SALT LAKE COMMUNITY COLLEGE
Skills
- Knowledge of anatomy and physiology
- Strong organizational skills
- Proficient in medical terminology
- HIPAA compliance
- Detail-oriented
- Hard-working
- Process improvement strategies
- Professionalism and ethics
- Patient confidentiality compliance
- Strong communication skills
- Insurance verification expertise
Timeline
Authorization and Eligibility Coordinator
Enhabit Home Health
03.2018 - Current
Quality Assurance Assistant
Intermountain Healthcare
05.2014 - 02.2018
Compliance
Intermountain Healthcare
12.2012 - 05.2014
Insurance Verification/Authorization Representative
Intermountain Healthcare
08.2007 - 12.2012
Registrar
Intermountain Healthcare
10.2004 - 08.2007
SOUTHERN VIRGINIA UNIVERSITY
SALT LAKE COMMUNITY COLLEGE
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