Laura Patriarca
South Bend,IN
Summary
Precertification Specialist with DULY/The South Bend Clinic & Surgicenter, proficient at streamlining authorization processes enhancing efficiency.
Skilled in medical documentation review and insurance verification successfully obtaining Authorization in a fast-paced environment.
Overview
17
17
years of professional experience
Work History
Precertification Specialist
DULY/The South Bend Clinic & Surgicenter
06.2021 - Current
- Adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Analyzed trends in denials or authorization delays to identify opportunities for improvement within the precertification department.
- Reduced wait times for authorization by reviewing medical records and obtaining necessary documentation for medically necessary services within required timeframes.
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Performed various administrative tasks by filing, copying and faxing documents.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Utilization Review Specialist
Liberty Mutual
02.2008 - 05.2019
- Evaluated clinical documentation ensuring medically necessary
- Managed a high volume of cases efficiently by prioritizing tasks and maintaining strict deadlines for completion of reviews.
- Contributed to organizational success by participating in quality improvement initiatives related to utilization management processes.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Performed prior authorization review of services requiring notification.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Education
Certificate - Medical Coding/Billing And Clerical
Ivy Tech
South Bend, INSkills
- Documentation review/Authorization management
- Insurance verification expertise
- Medical terminology proficiency
- HIPAA compliance awareness
- Knowledgeable NextGen and EPIC
- Professionalism and ethics
Timeline
Precertification Specialist
DULY/The South Bend Clinic & Surgicenter
06.2021 - Current
Utilization Review Specialist
Liberty Mutual
02.2008 - 05.2019
Certificate - Medical Coding/Billing And Clerical
Ivy Tech
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