Authorization Specialist
Saint Francis Healthcare System
02 2019 - Current
- Provide excellent customer service.
- Ability to navigate insurance websites for insurance verification and eligibility.
- Collected payments for co-pays and estimated financial responsibility.
- Responsible for multiple work ques.
- Generated estimates in a timely and accurate manner.
- Tracked referral submission during facilitation of prior authorization issuance.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Pre-certified medical and radiology procedures, surgeries and echocardiograms.
- Precisely evaluated and verified benefits and eligibility.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Initiated patient care meetings with multidisciplinary team to revise plan of care as patient condition warrants.
