Karen Yarb
Largo,FL
Summary
- Verifying health insurance information and obtaining authorizations, pre-certifications, and/or referrals for medical outpatient elective services.
Assists patients, clinical teams, physicians, and their staff, the BayCare central business office, and denials management with information and process details for timely turnaround for authorizations.
Utilizes electronic scheduling/registration/financial systems, payer’s websites, and recorded calls to validate health coverage and benefits in processing approval for medical services.
Maintains proper documentation in Cerner and Pixcert.
Works closely with Managed Care and understands health insurances rule sets, manuals, and contract language.
Overview
24
24
years of professional experience
Work History
Authorization Specialist
BayCare Health System Inc.
06.2015 - Current
- Processed and certified documents for accuracy and compliance with government regulation.
- Verifying health insurance information and obtaining authorizations, pre-certifications, and/or referrals for medical outpatient elective services.
- Assists patients, clinical teams, physicians, and their staff, central business office, and denials management with information and process details for timely turnaround for authorizations.
- Utilizes electronic scheduling/registration/financial systems, payer’s websites, and recorded calls to validate health coverage and benefits in processing approval for medical services.
- Maintains proper documentation in Cerner and Pixcert.
- Works closely with Managed Care and understands health insurances rule sets, manuals, and contract language.
REFERRAL COORDINATOR
West Central Gastroenterology
01.2005 - 05.2015
- Responsible for insurance verification of all upcoming appointments in a fast paced, four-provider practice
- Update and correct insurance information to ensure claims are processed to insurance companies for payments
- Compile both In and Out of network authorizations for upcoming procedures and office visits
- Calculate prices for patient's responsibility, upcoming procedures and office visits while keeping the patient informed of amounts due
- In charge of all aspects of infusion patients including: insurance/payments/appointments/rebates due from assistance programs
- Oversee the calculation of payroll hours
- Back-up coverage for office manager and assist with running of office phones and appointments.
Patient Rep II
BayCare Health System Inc.
01.2000 - 01.2004
- Verified any changes or data updates to patient records and checked insurance information at each appointment.
- Observed all facility rules and regulations regarding patient data to promote confidentiality and integrity.
- Informed patients of excessive wait times and offered to reschedule appointments.
- Monitored patient flow throughout day to maintain appointment times and schedules.
Education
High School Diploma -
St. Petersburg High School
St. Petersburg, FL06.1984
Skills
- HIPAA Compliance
- Multitasking Capabilities
- Continuous Learning
- Conflict Resolution
- Data Entry Proficiency
- Effective Communication
- Problem Solving Abilities
- Interpersonal Skills
- Professionalism
- Team Collaboration
- Time Management
- Insurance Verification
- Medical Terminology Expertise
Timeline
Authorization Specialist
BayCare Health System Inc.
06.2015 - Current
REFERRAL COORDINATOR
West Central Gastroenterology
01.2005 - 05.2015
Patient Rep II
BayCare Health System Inc.
01.2000 - 01.2004
High School Diploma -
St. Petersburg High School
Similar Profiles
LINDSEY C. MCCARTHYLINDSEY C. MCCARTHY
Licensed Health Advisor at BayCare Health System (BayCare Health Plans)Licensed Health Advisor at BayCare Health System (BayCare Health Plans)
Rachael MyattRachael Myatt
Registered Nurse, Post-Anesthesia Care Unit at BayCare Health System - St. Anthony's HospitalRegistered Nurse, Post-Anesthesia Care Unit at BayCare Health System - St. Anthony's Hospital
ROLSIE JOY GLANZERROLSIE JOY GLANZER
Medical Surgical Telemetry Clinical Nurse III at BayCare Health System Inc.Medical Surgical Telemetry Clinical Nurse III at BayCare Health System Inc.
Bianca WoodsBianca Woods
Registered Nurse at BayCare Health SystemRegistered Nurse at BayCare Health System
Gabrielle CaseyGabrielle Casey
Sales Agent at US Health AdvisorsSales Agent at US Health Advisors