Verify/review the information received, communicate with the patient's provider/pharmacy if additional information is needed, and facilitate the clinical
Monitors incoming patient orders and gathers information needed to complete the pre-authorization and scheduling of an order
Verifying initial and ongoing payer authorization and eligibility of home care services
Reviewed and processed prior authorization requests for medical procedures, medications, and durable medical equipment
Verified patient eligibility and insurance coverage to ensure compliance with payer guidelines
Communicated with insurance companies to obtain approval or denial decisions for prior authorization requests
Maintained accurate records of all prior authorization activities in electronic health record systems
Adhered to HIPAA regulations and maintained strict confidentiality when handling sensitive patient information during the prior authorization process
Utilized knowledge of medical terminology, CPT codes, ICD-10 codes, and HCPCS codes.
Receptionist
Baptist Health Arkansas
08.2015 - 07.2024
Full Time
40+ hours/week
Scheduled and confirmed appointments
Answered and directed incoming calls using multi-line telephone system
Served visitors by greeting, welcoming and directing to appropriate personnel
Maintained an organized front desk area, including managing visitor sign-in process and distributing badges
Assisted with administrative tasks such as filing documents, photocopying materials, and preparing correspondence
Trained new receptionists on office procedures and protocols to ensure consistent service delivery across shifts
Surgery scheduling
Managed patient registration process, ensuring accurate and timely collection of demographic and insurance information
Assisted patients with completing necessary forms and provided guidance on financial assistance programs
Responded to inquiries from patients regarding appointment scheduling, medical records requests, and general information about the facility
Coordinated referrals to specialists or other healthcare facilities as required by physicians' orders
Authorized surgical requests in accordance with applicable plan guidelines.
ER Admitting Representative
Mercy Hospital
03.2017 - 01.2018
Full Time
50+ hours/week
Efficiently registered and admitted patients, ensuring accurate and complete demographic information
Verified insurance coverage and obtained necessary authorizations for medical services
Maintained strict confidentiality of patient records in compliance with HIPAA regulations
Assisted in the collection of co-pays, deductibles, and outstanding balances at the time of registration
Updated patient records as needed, including changes in contact information or insurance coverage
Ancillary Processor
Golden Living
11.2012 - 01.2017
Full Time
40+ hours/week
Provide general clerical and administrative support
Preparing letters and documents, receiving and sorting
Assist with data entry and update of relevant database
Responsible for evaluation, procession, dissemination and maintenance of all resident admission information
Maintain ongoing communication with the facility leadership and clinicians to ensure continual flow of financial information with assigned centers
Review all admission and readmission documents
Review payor status changed notices, communicates changes to Billing Specialists
Call Center Representative
Answer Fort Smith
01.2014 - 02.2015
Part Time
25 hours/week
Handled a high volume of inbound customer calls
Provided excellent customer service by addressing inquiries, resolving complaints, and ensuring customer satisfaction
Implemented effective strategies to de-escalate challenging situations with upset or irate customers while maintaining professionalism at all times
Managed multiple communication channels including phone calls, emails, live chat support etc
Maintained confidentiality of sensitive customer information according to established data protection guidelines
Customer Service Rep
AT&T
05.2009 - 03.2010
Full Time
40 hours/week
Managed a high volume of incoming customer inquiries via phone, email, and chat
Provided exceptional customer service by promptly addressing and resolving customer issues and concerns
Assisted customers with product selection, order placement, and tracking shipments
Processed returns and exchanges according to company policies and procedures
Coordinated and scheduled daily shipments, ensuring timely delivery of goods to customers
Managed the dispatching software system to assign routes efficiently and optimize driver schedules
Maintained confidentiality of sensitive information related to customer orders, pricing agreements, and supplier contracts
Customer Service Representative
Experian Consumer Direct
03.2007 - 08.2007
Part time
32 hours/week
Provided exceptional customer service by promptly addressing inquiries, resolving issues, and ensuring customer satisfaction
Managed high volume of incoming calls and emails, consistently meeting or exceeding performance metrics for response time and resolution
Proactively reached out to customers who had unresolved issues or complaints to ensure their concerns were addressed promptly and satisfactorily
Demonstrated strong product knowledge
Maintained a calm demeanor during challenging interactions with upset or dissatisfied customers while actively listening to their concerns and finding appropriate solutions
Handled sensitive customer information with discretion, adhering to strict data privacy regulations at all times.
Documented customer interactions and transactions for accurate, up-to-date records.