Lauren Gallagher
Mechanicsville,VA
Summary
Highly skilled Insurance Authorization Specialist with extensive experience in verifying and obtaining insurance authorizations for medical procedures and services. Proven ability to navigate complex insurance policies and guidelines to ensure accurate and timely approvals. Detail-oriented and efficient in managing large volumes of authorizations, while maintaining a high level of accuracy. Seeking a challenging position in a reputable organization where I can utilize my expertise to contribute to the overall success of the team.
Overview
13
13
years of professional experience
Work History
Pre-Authorization Specialist
Neurosurgical Associates
Remote
09.2019 - Current
- Processed and verified insurance policies,ensuring accuracy and adherence to company policy
- Collaborated with healthcare providers and insurance companies to obtain necessary documentation and authorization for approval of medical procedures and treatments
- Conducted thorough reviews of insurance policies and coverage to determine eligibility and benefits, resulting in improved claim acceptance rates
- Assisted patients in understanding insurance plans, explaining coverage limitations, and resolving billing and authorization issues, enhancing overall customer satisfaction.
- Followed all company policies and procedures to deliver quality work.
- Developed strong client relationships through consistent communication and attentive service.
Surgical Coordinator
Dominion Eye Associates
Richmond, VA
09.2011 - 09.2019
- Efficiently managed high volume caseloads while maintaining meticulous attention to detail in scheduling logistics and documentation.
- Maintained strict adherence to HIPAA regulations, protecting the privacy of patient information at all times.
- Enhanced surgical team communication by maintaining accurate schedules and promptly addressing any changes or concerns.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Served as a liaison between patients, families, clinicians, and hospital staff throughout the entire surgical process.
- Provided comprehensive education materials for patients regarding their upcoming surgery, answering questions and alleviating concerns related to the procedure itself or recovery expectations afterward.
- Conducted thorough chart reviews prior to surgery, identifying potential issues or discrepancies requiring resolution before proceeding with procedures.
- Coordinated with facilities to set up surgeries for Number Surgeon type.
- Served as a trusted resource for patients and families during emotionally challenging times, providing compassionate support and guidance throughout the surgical journey.
- Collaborated with insurance providers to verify coverage and obtain necessary authorizations for surgical procedures.
- Contributed to a reduction in surgery cancellations by closely monitoring patient compliance with pre-surgical instructions.
- Streamlined patient check-in process for surgical appointments, reducing wait times and increasing satisfaction.
- Organized transportation arrangements for post-operative patients when necessary, easing their transition from hospital to home recovery environments.
- Verified insurance coverage and obtained pre-authorizations.
- Resolved scheduling conflicts to maintain high-quality patient services.
- Arranged pre-operative and post-operative appointments for surgical patients.
- Expertly managed planning, scheduling, and coordination of outpatient procedures.
- Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Updated patient records to reflect upcoming surgeries and medical histories.
- Answered phone calls and messages for Number-physician Type medical facility, scheduling appointments, and handling patient inquiries.
- Performed various administrative tasks by filing, copying and faxing documents.
- Obtained payments from patients and scanned identification and insurance cards.
- Registered and verified patient records before triage with most up-to-date information.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
Education
Associate's degree - Medical Billing & Coding
Medical Career Institute
Richmond, VA08.2011
Skills
- Insurance Verification (9 years)
- CPT Coding
- Medical Billing
- ICD-10
- Medical Office Experience (9 years)
- EMR Systems
- Medical Terminology (9 years)
- Medical Records (9 years)
- Multi-line Phone Systems (10 years)
- Medical Scheduling (9 years)
- Medical Receptionist (6 years)
- Phone Etiquette (10 years)
- HIPAA (10 years)
- ICD coding
- ICD-9
- Office experience (10 years)
- Insurance verification (9 years)
- HIPAA (9 years)
- Patient Care
- Data Entry
- Hospital Experience
- Transcription
- Medical Coding
- QuickBooks
- Expert Problem Solving
- Documentation Management
- Customer Relations
- Attention to Detail
- Patient confidentiality
- HIPAA Compliance
- Insurance Coverage Verification
- Data entry proficiency
- Coverage and Authorizations
- Communication and Interpersonal Skills
- Coordination and Scheduling
- Insurance Billing
- Medicaid knowledge
- Healthcare Industry Knowledge
- Electronic Medical Records
- Patient contact
- Prior authorization processing
- Medical Terminology
- Document Management
- Understanding of medical terms
- Patient Communication
- Proficient in Software
- Data Verification
- Meditech
- Radiology Knowledge
- Allscripts
- Insurance Verification
- Organization and Time Management
- Patient Health Information Access
- Insurance Authorizations
Personal Information
Title: Insurance Specialist
Timeline
Pre-Authorization Specialist
Neurosurgical Associates
09.2019 - Current
Surgical Coordinator
Dominion Eye Associates
09.2011 - 09.2019
Associate's degree - Medical Billing & Coding
Medical Career Institute