Katie Sanchez
Lodi,NJ
Summary
Assisting patients with prior authorizations for primary care physicians. Obtaining insurance referrals for specialists. Coordinating with imaging facilities to have patients procedures scheduled. Obtaining prior authorizations for medication electronically. Athena health used for electronic medical records.
Insurance professional with strong background in verifying insurance coverage and benefits. Skilled in navigating complex systems, resolving discrepancies, and ensuring accurate information. Known for excellent team collaboration and adaptability to changing needs. Efficient in communication, problem-solving, and maintaining high standards for quality and results.
Overview
7
7
years of professional experience
Work History
Insurance Verification Specialist
University Reproductive Associates
11.2024 - 03.2025
- Verify Insurance Benefits
- Use insurance portals or clearinghouse systems to check coverage
- Confirm:
- Active coverage status
- Deductibles, copays, and out-of-pocket costs
- In-network vs
- Out-of-network status
- Authorization requirements for procedures/services
- If additional clarification is needed, contact the insurance provider
- Speak to Insurance Providers on Behalf of the Patient
- Call the insurance company for any unclear benefit details
- Ask about specific coverage for the services the patient will receive
- Document all conversations and reference numbers in the EMR
- Communicate Insurance Benefits to the Patient
- Explain coverage details, including:
- Copays, deductibles, and coinsurance
- Any out-of-pocket expenses
- Need for prior authorization (if applicable)
- Answer any questions and provide guidance on payment options
- Complete Patient Paperwork & Obtain Signatures
- Have the patient fill out necessary forms (consent, medical history, HIPAA, financial agreement)
- Ensure all paperwork is complete and upload it to the EMR
- Collect & Process Payments
- Review patient responsibility based on insurance verification
- Collect copays, deductibles, or self-pay amounts
- Provide receipts and update payment records in the EMR
- Confirm Final Details & Next Steps
- Ensure all information is accurately entered into the EMR
- Confirm that the patient is ready for their appointment
- Answer any last questions regarding their visit, insurance, or billing
- Log out of the EMR system for security purposes
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
Patient Registrar
Sarasota Memorial Hospital
04.2022 - 07.2022
- Greet the Patient & Verify Appointment
- Welcome the patient with a friendly and professional demeanor
- Confirm the appointment details (date, time, provider)
- If the patient is a walk-in, check availability and inform them of wait times
- Enter Patient Information into the EMR System
- Search for the patient's record to check if they are an existing patient
- If new, create a new patient profile and enter:
- Full name
- Date of birth
- Address & contact details
- Emergency contact
- Insurance information (if applicable)
- Complete Required Paperwork
- Provide necessary forms (consent, medical history, privacy agreements)
- Ensure all fields are filled out completely
- Scan and upload signed forms into the EMR system
- Verify & Update Information
- Confirm personal details with the patient
- Update any changes in the system (address, phone number, insurance, etc.)
- Ensure accuracy in insurance details to avoid claim denials
- Collect & Process Payments
- Check insurance eligibility and coverage for services
- Inform patients about copays, deductibles, or self-pay options
- Accept payments (credit card, cash, checks, or digital payment methods)
- Provide a receipt and document the transaction in the EMR system
- Provide Additional Information
- Give instructions for the next steps (waiting area, provider's room, or lab tests)
- Inform the patient about office policies, upcoming appointments, and follow-ups
- Answer any patient questions regarding their visit
- Final Check & Completion
- Ensure all required data is saved in the EMR
- Confirm that the patient's chart is updated and ready for the provider
- Log out of the EMR system for security purposes
- Contributed to a positive patient experience by providing exceptional customer service and addressing any concerns or questions throughout their visit.
Surgical Scheduler
Summit Health Management
08.2021 - 02.2022
- Assisting patients with prior authorizations for Internal Medicine Physicians
- Obtaining insurance referrals for specialists
- Coordinating with imaging facilities to have patients procedures scheduled
- Obtaining prior authorizations for medications using an electronic prior authorization system
- Coordinated with facilities to set up appointments for MRI and Cat Scans.
Medical Receptionist
Synergy Spine Care
08.2020 - 08.2021
- Answering phones, greeting patients and visitors and scheduling appointments in a professional and timely manner
- Maintains a polite, consistent phone manner using pleasant telephone etiquette
- Register new patients and updates existing patient demographics by collecting patient information including personal and financial information during the check in process
- Facilitates patient flow by notifying the Medical Assistants of patient arrival, being aware of delays, and clearly communicating status with patients and clinical staff
- Managed multi-line phone system and pleasantly greeted patients.
Patient Care Coordinator
Hearing Life
08.2018 - 08.2020
- Handling high call volume and being able to multitask
- Handling outgoing and incoming faxes, ordering medications as well as insurance verification
- Training new employees coordinate doctors schedule, routine cleaning on the hearing aid devices
- Works well under pressure and a team player
- Organized community health events, raising awareness about preventative care and healthy lifestyle choices.
- Organized patient records and database to facilitate information storage and retrieval.
Education
Associate's degree - Healthcare Management
Berkeley College
Woodland Park, NJ05.2020
Skills
- Triage
- Workers' compensation law
- HIPAA
- Surgery
- Medical records
- Medical office experience
- Insurance Verification
- EMR systems
- Communication skills
- Patient Care
- Medical Billing
- Computer Skills
- Microsoft Word
- Administrative experience
- Medical Terminology
- Medicare
- SharePoint
- Medical Scheduling
- Epic
- Athena
- Microsoft Office
- Data Entry
Personal Information
- Willing To Relocate: Anywhere
- Authorized To Work: US for any employer
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Insurance Verification Specialist
University Reproductive Associates
11.2024 - 03.2025
Patient Registrar
Sarasota Memorial Hospital
04.2022 - 07.2022
Surgical Scheduler
Summit Health Management
08.2021 - 02.2022
Medical Receptionist
Synergy Spine Care
08.2020 - 08.2021
Patient Care Coordinator
Hearing Life
08.2018 - 08.2020
Associate's degree - Healthcare Management
Berkeley College
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