Detail oriented Healthcare Billing and Authorization Specialist with expertise in physician billing and patient financial services. Secured pre-certifications, accelerated revenue cycles, and reduced claim denials. Navigated complex insurance portals while ensuring compliance and collaborating with clinical teams to optimize patient care and financial recovery.
Work History
Physician Billing and Patient Financial Services
1 Year 11 Months
MaineHealth | 09.2024 - Current
Analyzed and processed complex medical claims to ensure accurate reimbursement.
Collaborated with healthcare providers to resolve billing discrepancies effectively.
Works effectively in fast-paced environments.
Skilled at working independently and collaboratively in a team environment.
Streamlined insurance authorization processes to enhance operational efficiency and reduce turnaround times.
Analyze authorization trends to identify areas for process improvement and implement strategic solutions.
Facilitates communication between patients, insurance companies, and medical staff to resolve authorization issues promptly.
Precert Insurance Authorization Specialist
4 Years 4 Months
Southern Ohio Medical Center | 05.2020 - 09.2024
Maintained a comprehensive understanding of insurance companies' preauthorization guidelines and requirements, including specific coverage criteria and medical necessity requirements, to ensure accurate and successful precertification of services
Developed and maintained strong relationships with insurance providers to ensure smooth and timely processing of authorization requests
Collaborated with healthcare providers to gather necessary information for insurance pre-authorization and ensure accurate and complete documentation.
Registar
3 Years 3 Months
Southern Ohio Medical Center | 02.2017 - 05.2020
Develop and maintain a comprehensive filing system to ensure accurate and efficient record keeping for patient registrations
Collaborate with other departments to ensure accurate and timely patient registration and billing processes
Manage and update patient registration forms to ensure compliance with changing regulations and requirements
Ensure the confidentiality and security of patient registration information by implementing and enforcing data protection measures.
Environmental Services
5 Years 3 Months
Southern Ohio Medical Center | 11.2011 - 02.2017
Implement and maintain a comprehensive waste management program in accordance with local, state, and federal regulations to ensure the safe and proper disposal of hazardous and non-hazardous waste materials
Develop and implement an infection control program to minimize the spread of diseases and ensure a clean and safe environment for patients and staff.
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