Margaret Hurst
Delray Beach,FL
Summary
At Conviva Care Solutions, I excelled in referral coordination, ensuring HIPAA compliance and seamless patient transitions. My expertise in Microsoft Office and strong work ethic led to improved referral processing efficiency and enhanced customer service. I adeptly managed insurance verifications and data entry, contributing to the development of productive insurance company relationships and effective referral strategies. Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.
Overview
14
14
years of professional experience
Work History
Referral Cord Scheduler 1
Conviva Care Solutions
Delray Beach, FL
01.2011 - Current
- Ensured compliance with HIPAA regulations when handling patient information.
- Coordinated with external agencies to ensure timely processing of referrals.
- Collaborated with internal departments to ensure smooth transitions for referred patients.
- Reviewed demographic, clinical and insurance information before sending to referred specialists.
- Communicated with patients with compassion while keeping medical information private.
- Provided exceptional customer service, addressing patient inquiries and concerns with empathy and professionalism.
- Performed data entry related to referrals into electronic health record systems.
- Reviewed non-contracted instrumentation for spine surgeries and initiated vendor contract evaluations in conjunction with operations staff and orthopedic spine and neurological spine specialists.
- Provided excellent customer service to both internal and external customers.
- Developed productive working relationships with numerous insurance company representatives.
- Worked closely with billing departments to ensure accurate coding and billing for referred services.
- Participated in regular meetings to discuss referral strategies, network expansion, and program performance metrics.
- Compiled, recorded, or coded data from referrals or surveys using computer or specified form.
- Resolved issues arising during the referral process, including insurance denials and appointment scheduling conflicts.
- Coordinated with healthcare providers to verify patient insurance coverage and obtain necessary pre-authorizations for treatments.
- Verified documents and associated records to catch and resolve discrepancies.
- Reviewed medical records to determine if additional services are needed prior to making a referral.
- Participated in training and professional development opportunities to stay current with best practices in referral coordination.
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Education
Some College (No Degree) - EMT HEALTHCARE
The University of Alabama
Tuscaloosa, ALSkills
- Client-specific scheduling
- Schedule verification
- Recordkeeping proficiency
- Microsoft Office Suite
- Market forecasting
- Deadline tracking
- Strong work ethic
- Medical terminology
- Insurance verification
- Data entry
- Attention to detail
Timeline
Referral Cord Scheduler 1
Conviva Care Solutions
01.2011 - Current
Some College (No Degree) - EMT HEALTHCARE
The University of Alabama
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