Lisa Robertson
Mesa,Az
Summary
Hardworking Prior Authorization and Insurance Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 12 years of managing documentation. Considered team player with exemplary multitasking skills. Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows.
Overview
27
27
years of professional experience
Work History
Medical Insurance and Authorization Specialist
National Cardiovascular Partners
MESA, AZ
10.2016 - Current
- Assisted in the care of patients, extensive insurance verification, Calculated premiums collections, and registered patient demographics.
- Worked hand in hand with the cardiac cath labs to ensure patients are scheduled in a timely and effective manner.
- Worked with ICD 10 codes, billing, and EMR systems
- Daily and weekly accounting to obtain our percentages for insurance verification and authorization turnaround time.
- Made contact with insurance carriers to discuss policies and individual patient benefits. Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained confidentiality of patient finances, records and health statuses, and modified, updated and processed existing insurance policy information.
- Reviewed and processed 300 patient cases per week and verified insurance coverage information, prepared reports, and created excel sheets to display the breakdown of insurance coverage.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Responded to correspondence from insurance companies.
- Evaluated the accuracy and quality of data entered into multiple EMR programs
- Displayed consistent, positive attitude towards customers, peers and other personnel, even during high-stress situations. Communicated effectively with staff members of operations, finance and clinical departments.
Medical Assistant/Administrative Office Manager
Cardiovascular Inst. of Az
MESA, AZ
09.2008 - 10.2016
- Assisted in the care of patients, check in and check out process, insurance verification, collections, registered patient demographics, referrals, obtained authorizations for hospital and in office procedures and care.
- Scheduling patients for testing and hospital procedures, filed documentation in coordinate with hospital regulations, filled prescriptions for patients in and out of the hospital
- Worked with ICD 10 codes, billing, and EMR systems
- Communicated effectively with staff members, physicians and patients, employing active listening and interpersonal skills.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing and accounts receivable.
- Provided proper scheduling of patients, ensuring timely and effective allocation of resources and calendars.
- Developed close working relationships with front office and back office staff.
- Built relationships with physicians to create a steady referral pipeline, and consulted with healthcare professionals on business decisions.
- Managed staffing requirements and provided training to all employees, I oversaw accounting, budgeting, and financial reporting, medical inventory, accounts payable and receivable, bank reconciliations for the medical practice and other personal property and real estate (Sun Medical Management)
Office Assistant/Accounts Payable Clerk/Scheduling Coordinator
Sante Fe Plumbing
11.2004 - 09.2008
- Administrative functions including calendaring and scheduling, daily and monthly marketing analysis, financial statements (weekly, monthly, and yearly), invoices, inventory, accounts payable and receivable, bank reconciliations, along with maintaining customer accounts
- Coordinating and arranging travel for the owner/operator, maintained time cards, customer service with all employees and vendors, scheduled appointments, multi-phone lines, daily weekly and monthly revenue, taxes, budgeting and finance, sales, production, payroll
- Investigates, evaluates, and solves unit’s routine and non-routine issues, authorizes payments with established vendors and warranty companies
- Plans conferences, meetings, and special events with owner/operator.
Accounting Specialist
Americovers LLC
01.2000 - 01.2006
Production Manager
Savers
01.2002 - 01.2005
- Supervised and managed 15+ employees with full responsibility of interviewing, hiring, and training personnel
- Ensured production process, plan and execute production schedule and performance, resolve any employee issues, improved efficiency of production, coordinate with vendors, contractors and suppliers
- Ensure high quality customer satisfaction, maintained productions goals, designed new programs for better effectiveness of employees, maintained compliance with all codes and regulations
- Managed logistics, shipping, receiving, delivery and distribution.
Education
8th - management / Science
Grand Canyon University
Phoenix, AZDual Bachelor’s Degree - undefined
8th - undefined
Western Governors University
Bachelors - undefined
Associates Degree - Business Management / Criminal Justice
University Of Phoenix
Skills
- Insurance Claim Forms Review
- New Policies Processing
- Coverage Determination/Clinical Messaging
- Insurance Authorizations
- Demographics Information
- Authorization Verification
- Healthcare Terminology
- Health Insurance Plan Knowledge
Timeline
Medical Insurance and Authorization Specialist
National Cardiovascular Partners
10.2016 - Current
Medical Assistant/Administrative Office Manager
Cardiovascular Inst. of Az
09.2008 - 10.2016
Office Assistant/Accounts Payable Clerk/Scheduling Coordinator
Sante Fe Plumbing
11.2004 - 09.2008
Production Manager
Savers
01.2002 - 01.2005
Accounting Specialist
Americovers LLC
01.2000 - 01.2006
8th - management / Science
Grand Canyon University
Dual Bachelor’s Degree - undefined
8th - undefined
Western Governors University
Bachelors - undefined
Associates Degree - Business Management / Criminal Justice
University Of Phoenix
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