Summary
Overview
Work History
Education
Skills
Certification
Work Preference
Work Availability
Software
Timeline
BusinessAnalyst

Lori Robinson

Oxford,PA

Summary

Prior Authorization Specialist with expertise in insurance verification and medical coding. Demonstrated success in improving healthcare coordination and expediting authorization processes, resulting in timely patient service access. Proficient in data documentation and building strong provider relationships, enhancing patient care efficiency. Recognized for high productivity and swift task completion, with specialized skills in ICD-10, CPT coding, and regulatory compliance.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Prior Authorization Specialist

Med-Metrix
Upland , PA
04.2023 - Current
  • Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
  • Utilized medical coding knowledge to accurately process and document authorization requests.
  • Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
  • Coordinated with other departments to obtain additional information needed for prior authorization.
  • Coordinated with healthcare providers to gather necessary patient information for prior authorization requests.

Prior Authorization Specialist

Crozer Chester Medical Center
Upland, PA
04.2021 - 04.2023
  • Facilitated communication among providers, payers, and health plans regarding prior authorization processes.
  • Verified patient insurance coverage, including benefits and authorizations for medical services.
  • Reviewed prior authorization requests to ensure accuracy and completeness of information.
  • Responded promptly to inquiries from providers, patients, and payers about prior authorization status.
  • Researched clinical criteria to determine eligibility for requested services based on plan provisions.
  • Developed relationships with external vendors to enhance pre-authorization services.
  • Coordinated with departments to gather additional information for prior authorization needs.
  • Trained new staff on prior authorization procedures and company policies.

Patient Access Registrar

Crozer Chester Medical Center
Glen Mills, PA
06.2010 - 04.2021
  • Ensured accurate and efficient completion of all patient registration forms.
  • Answered patient and provider inquiries regarding registration issues promptly.
  • Utilized EMR and EHR software for entering patient demographic data.
  • Inputted lab test and radiology orders, adhering to established accuracy guidelines.
  • Maintained up-to-date knowledge of healthcare regulations through continuing education.
  • Verified insurance eligibility and collected required co-payments or deposits.
  • Greeted patients and visitors professionally, offering assistance as needed.
  • Assisted in scheduling appointments via telephone and web portal.

Education

Certificate - Medical Coding

AAPC
Salt Lake City, UT
11-2019

Certificate - EMT

Delaware County Community College
Media, PA
06-1991

High School Diploma -

Penn Wood
Lansdowne, PA
06-1990

Skills

  • Insurance verification and authorization
  • Medical coding
  • Healthcare coordination
  • Data documentation
  • Customer relationship management

Certification

CPR Certifed 10/2024

Work Preference

Work Type

Full Time

Work Location

Remote

Important To Me

Work-life balanceFlexible work hoursHealthcare benefitsWork from home optionPaid sick leave401k matchPersonal development programs

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Software

Cerner

Timeline

Prior Authorization Specialist

Med-Metrix
04.2023 - Current

Prior Authorization Specialist

Crozer Chester Medical Center
04.2021 - 04.2023

Patient Access Registrar

Crozer Chester Medical Center
06.2010 - 04.2021

Certificate - Medical Coding

AAPC

Certificate - EMT

Delaware County Community College

High School Diploma -

Penn Wood

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