Lakora Kennedy

This position is responsible and accountable for the timely and accurate insurance clearance of pre and post inpatient and outpatient accounts from Epic Work Queues as assigned. • Performs insurance benefits verification to confirm eligibility for scheduled or prospective services. • Reviews for appropriate coordination of benefit and identifies discrepancies prior to clearance. • Determines insurance authorization requirements for services scheduled or received. • Ensures all scheduled services are authorized and appropriate notification and/or referral is obtained prior to the date of service to ensure payment for services. • Ensures clear and timely documentation of all insurance clearance activities and outcomes, including authorization information in Epic. Performs all required follow-up to secure authorization pre-service, including follow-up with providers' offices, scheduling departments and insurance companies. • Performs medical necessity review for applicable services to ensure diagnosis is covered under insurance carrier clinical bulletin policy for outpatient appointments as scheduled. • Determines patients' benefit level based on in-network or out-of-network benefits. • Identifies non-par plan status and follows appropriate out of network workflow based on service and payor type. Calculates and communicates patients' estimated out of pocket hospital financial responsibility pre-service for scheduled or utilizing the Epic Estimator tool or International Calculator. • Understands performance measures and is accountable for meeting monthly target goals as determined based on service and payer. • Exercises skill in prioritizing assignments in order to complete work in a timely manner when there are changes in workload, assignments, and pressures of deadlines, competitive requirements and/or a heavy workload. • Demonstrates optimal customer service skills when interfacing with patients, patients' families, physicians, physician office staff, and hospital colleagues. • Demonstrates excellent communication skills; uses appropriate vocabulary and grammar when obtaining and conveying information to physicians, nurses and staff at various levels; in person, over the phone, in writing and in electronically sent messages. • Works collaboratively with and acts as a liaison with a variety of internal departments within NYULH, external business partners, external departments, and NYULH's contracted payers. • Works independently, takes initiative, and escalates to leadership appropriately. • Responsible for answering and redirecting phone calls as needed and responding to emails timely. • Adhere to compliance and departmental policies and procedures including compliance with 100% of HIPAA requirements, required trainings, and other Hospital mandated activities. • Perform other duties as assigned.

• Acts as liaison across multiple facility departments such as pharmacy, Ambulatory Care OPD, Emergency Room, Behavioral Health, Finance etc.
• Screen patients to determine eligibility for insurance and navigate them Metroplus, Healthfirst, and accepted HMOs for enrollment.
• Enroll patients that have been interviewed by an insurance carrier and determined ineligibility into NYC CARE or H&H Options.
• Assist patients with billings inquiries, determine patient’s responsibility, and collect payment in full and/or set up payment arrangement.
• Responsible for updating and verifying patient demographics via EPIC and/or any of the legacy systems
• Scanning pertinent information in EPIC Such as Photo ID’s, insurance cards, financial documents, etc.
• Process payments in the form of Cash, Money Order, Checks, debit, and credit cards using EPIC, My Chart Pay as guest, and electronic card readers.

• Assisted in the training of new hires in the surgical operating room, inpatient and outpatient rooms, offices, pharmacy, and laboratory
• Ordered EVS supplies
• Worked in the stockroom and ensured that they are properly stored in accordance with the state safety guidelines and regulations
• Maintained a clean and organized storage area for cleaning equipment and supplies
• Responsible for the logging in and out of floor machine inventory
• Followed Environmental Services vendor’s (Crothall Healthcare Inc) 10-steps cleaning guidelines.

• Conducted patient interview to obtain identifying information, such as demographic, biographic and insurance status.
• Generated medical record numbers for new patient.
• Performed systems checks to verify insurance coverage.
• Verified third party coverage and obtain authorizations when necessary
• Revised patient information in unity based on documentations provided by patients.
• Performed all other duties assigned by supervisor.