LORI R ROSADO
Trenton,NJ
Summary
Enthusiastic about helping patients get necessary medical support by obtaining authorizations, scheduling procedures and coordinating paperwork. Detail-oriented and proactive with good relationship-building skills, a hardworking nature and an adaptable approach. Proficient in Epic.
Overview
14
14
years of professional experience
Work History
Car Precert II
Rutgers University Rutgers Health
12.2023 - Current
- Organizes and monitors scheduled procedures, IV infusions, and medications, ensuring pre-certification status is current.
- Verifies insurance eligibility and benefits via phone and/or internet.
- Secures all pre-certification for medicines in all departments.
- Communicates effectively with patients, pharmacist, pharmacies, Doctors and nurses with all actions taken during Precert process.
- Assign appropriate ICD 10 and CPT codes based on documentation and booking locations.
- Maintains confidentiality of all patient-related information and clinical information.
- Demonstrates efficiency and effectiveness in chart review functions.
- Verifies/review the information received, communicate with the patient's provider/pharmacy if additional information is needed, and facilitate the clinical review process.
Referral Specialist Patient Service Rep
Children's Hospital Of Philadelphia, CHOP
101 Plainsboro Road Plainsboro, Nj 08536
05.2022 - Current
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Verified insurance eligibility and coverage for patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Took copayments and compiled daily financial records.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Handled customer service inquiries in person, via telephone and through email.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
Patient Access Associates
Penn Medicine Princeton Medical Center
1 Plainsboro Road, Plainsboro, Nj 08536
08.2017 - 04.2022
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Providing excellent customer service by promptly answering patient inquiries.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Trained new staff on hospital processes and procedures.
- Educated patients on importance of preventive health care and insurance coverage.
- Verified patient insurance eligibility and entered patient information into system.
- Greeted and assisted patients with check-in procedures.
- Provided excellent customer service to patients and medical staff.
- Followed document protocols to safeguard confidentiality of patient records.
- Facilitated communication between patients and various departments and staff.
- Engaged with patients to provide critical information.
- Obtaining all Precertifications and Authorizations for all patients from emergency room, Direct admit inpatients, Labor and Delivery patients, NICO patients, and all outpatient services.
- Reviewing surge reports for the entire hospital by making sure all accommodation codes are in lined with all accommodation care ..
- Updating all accommodation codes to equal level of care manually.
- Admitting all inpatient and outpatient for services such as: Direct admissions, transfers within our facility to Acute rehab, transfers from outside facilities, Surgical care patients, preadmission testing patients, Ultrasound, MRI, Cat Scan and IR outpatient services .
- Scheduling and registering all walk-in X-ray and ekg patients
Patient Access Representative
Robert Wood Johnson Hospital
New Brunswick, NJ
11.2014 - 08.2017
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Providing excellent customer service by promptly answering patient inquiries.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Educated patients on importance of preventive health care and insurance coverage.
- Administrative duties: Verifying all patient information documents, insurance verification, answering phone lines, admitting patients for all inpatient and outpatient services such as labs, ekg, cardiac dynamics, x rays, ct scans, special procedures, surgeries, cath lab all same day and in house surgeries, pulmonary services, emergency visits, discharge visits, endoscopy, transplants
- Bedside duties such as verifying all information and obtaining all signatures of consent
Receptionist
Montgomery Internal Medicine Group
Princeton, NJ
07.2011 - 05.2014
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Kept reception area clean and neat to give visitors positive first impression.
- Answered phone promptly and directed incoming calls to correct offices.
- Responded to inquiries from callers seeking information.
- Resolved customer problems and complaints.
- Handled cash transactions and maintained sales and payments records accurately.
- Managed multiple tasks and met time-sensitive deadlines.
- Answered central telephone system and directed calls accordingly.
- Provided clerical support to company employees by copying, faxing, and filing documents.
- Restocked supplies and submitted purchase orders to maintain stock levels.
- Welcomed customers with friendly greeting, answered general questions, gathered nature of visit and directed to specific offices.
- Organized, maintained and updated information in computer databases.
- Answered questions and addressed, resolved, or escalated issues to management personnel to satisfy customers.
- Handled assignments independently with good judgement and critical thinking skills.
Education
Medical Assistant Degree - Medical Assisting
Anthem Institute
North Brunswick, NJ06.2010
High School Diploma -
Franklin High School
Somerset, NJ06.2007
High School Diploma -
Somerset County Technology Institute
Bridgewater, NJ06.2007
Skills
- Registration Requirements
- Forms and Spreadsheet Creation
- System Verification
- Patient Interviewing Skills
- Clinic Administration
- Demographics Information
- Medicaid
- Benefits Explanations
- Patient Engagement
- Appointment Confirmation
- Patient Account Reviews
- Coordinate Referrals
- Specialty Care
- HIPAA Compliance
- Appointment Scheduling
- Customer Service
- Professional Bedside Manner
- Claims Handling and Coverage Verification
- Epic savy
- Navinet, uhc online, availity, pear portal, one source and Humana savy
- Medical Billing
- Improve Patient Care
Timeline
Car Precert II
Rutgers University Rutgers Health
12.2023 - Current
Referral Specialist Patient Service Rep
Children's Hospital Of Philadelphia, CHOP
05.2022 - Current
Patient Access Associates
Penn Medicine Princeton Medical Center
08.2017 - 04.2022
Patient Access Representative
Robert Wood Johnson Hospital
11.2014 - 08.2017
Receptionist
Montgomery Internal Medicine Group
07.2011 - 05.2014
Medical Assistant Degree - Medical Assisting
Anthem Institute
High School Diploma -
Franklin High School
High School Diploma -
Somerset County Technology Institute