Kari Golden

Patient Access Specialist

Integris Baptist Medical Center

Oklahoma City, OK

01.2012 - Current

Responsible for creating and editing medical records thoroughly, accurately, and timely, adjusting to needs of each patient.
Patient Access duties performed in Emergency Dept, Outpatient Registration, Inpatient, Surgery Center, Labor & Delivery, Radiology, Heart Cath Lab, and more; Registered patients by completing face-to-face interviews, explained various admission forms and policies, acquired signatures for Consent to Treat, obtained demographics, insurance, and other medical & personal information.
Consistently meet and exceed collections goals, productivity goals, and audit accuracy.
Nominated by manager & to sit on a management created committee to gather feedback from co-workers about leadership and job satisfaction. The Baptist Registration Advisory Committee.
Then promoted to Patient Financial Advocate acting as a liaison between patient, registration department, & clinical staff.
Patient Financial Advocate duties include but not limited to: Contact insurance companies to obtain insurance benefits, explain and educate patients of their insurance benefits specific to Inpatient Delivery and Newborn benefits; Counseled patients on potential financial liabilities and payment requirements. Collect patient estimate responsibilities & previous balances; Obtain patient signatures on all legal documents, as well as explain documents to patient as needed, all while coordinating with clinical staff.
Then promoted to a specialized team processing referrals, and prior authorizations for pre-services only for Facility. Contacted insurance carriers to initiate & complete prior authorizations, notifications and pre-certifications for patients. Coordinated with medical staff to provide appropriate documentation when needed for pre-authorization requests.
Insured referrals from PCP to specialists had been obtained prior to starting prior authorization requests to prevent denial of payment from insurance. Cultivated positive relationships with ordering physicians and clinical staff to help facilitate referrals/ prior authorizations for Medicaid, Tricare, VA, Medicare, Indian Health, and Commercial insurance companies to ensure patient is clear to proceed for scheduled procedures / tests.
Resolved issues regarding prior authorization problems. Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
Responded to patient concerns and inquiries professionally and efficiently. Displayed strong telephone etiquette, effectively handling difficult calls. Managed daily workflow by prioritizing and organizing tasks to efficiently accomplish productivity goals.
Provided training and guidance to new hires and other co-workers on proper authorization processes and procedures.

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