Kathleen Joyner
Shreveport,LA
Summary
Precertification Specialist with experience in the healthcare industry. Familiarity with insurance coverage and patient authorization procedures proves advantageous. Strengths include strong communication skills, adaptability to evolving guidelines, and ability to efficiently handle high volume of precertifications. Contributed significantly to streamlining processes and improving patient satisfaction in previous roles.
Overview
16
16
years of professional experience
Work History
Precertification Specialist
Spine Institute of Louisiana
Shreveport, LA
06.2016 - 10.2024
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Compiled and submitted precertification requests for review by payers in accordance with established timelines.
- Provided follow-up on pending precertification requests to ensure timely processing.
- Maintained detailed documentation of all activities related to the precertification process.
- Evaluated clinical criteria against existing health plan guidelines to determine authorization status.
- Processed appeals when necessary following denial or rejection of claims due to lack of proper authorization.
- Reviewed patient medical records to determine medical necessity for requested services and procedures.
Medical Office Assistant
Louisiana Neurologic Specialties
Shreveport, LA
12.2009 - 05.2016
- Greeted patients and visitors in a professional and friendly manner.
- Scheduled patient appointments, answered incoming calls, and assisted with inquiries.
- Collected payments from patients for services rendered.
- Verified insurance coverage for each patient visit.
- Performed basic clerical duties such as filing documents, entering data into the computer system, photocopying forms and documents.
- Maintained medical supply inventory levels and ordered additional supplies when needed.
- Provided guidance to patients regarding their care plan or treatment options.
- Followed HIPAA guidelines to ensure confidentiality of patient information.
- Processed referrals for specialist visits or diagnostic tests.
- Assisted with scheduling follow-up appointments for patients after discharge from hospitalization.
- Communicated effectively with other healthcare staff members regarding patient care plans.
- Communicated with patients to resolve inquiries, schedule appointments and address billing questions.
- Collected co-pays and insurance data, applying full and proper payment to patient accounts.
- Scheduled and confirmed patient appointments and consultations.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
Medical Office Receptionist
Highland Clinic
Shreveport, LA
10.2008 - 10.2009
- Greeted patients and visitors in person or on the telephone, answering or referring inquiries.
- Provided information to patients regarding appointment scheduling, office hours, billing, and insurance policies.
- Scheduled patient appointments, collected co-pays and verified insurance coverage.
- Verified patient demographic and insurance information at each visit.
- Assisted with check-in, check-out procedures for all incoming, outgoing patients.
- Responded to messages from physicians, nurses and other healthcare staff in a timely manner.
- Answered multi-line phone system; directed calls accordingly to appropriate personnel or department.
Education
Business Administration
Bossier Parish Community College
Bossier City, LA05-1998
Skills
- Electronic Health Records Management
- Knowledgeable in Next Gen
- Telephone Etiquette
- Appointment Scheduling
- Verbal Communication
- Confidentiality
- Medical terminology proficiency
- Eligibility procedures
- Data Entry
- Effective communication skills
- Recordkeeping and data input
- Documentation and paperwork
Timeline
Precertification Specialist
Spine Institute of Louisiana
06.2016 - 10.2024
Medical Office Assistant
Louisiana Neurologic Specialties
12.2009 - 05.2016
Medical Office Receptionist
Highland Clinic
10.2008 - 10.2009
Business Administration
Bossier Parish Community College
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