Melissa Pippen
Odessa,TX
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
9
9
years of professional experience
Work History
Insurance Authorization Specialist
Texas Oncolgy
Remote
02.2021 - Current
- Collaborated with healthcare providers to ensure proper documentation for successful authorizations.
- Streamlined workflow processes for faster turnaround times, using data-driven approaches and continuous improvement techniques.
- Increased efficiency of the authorization process with effective communication among multidisciplinary teams.
- Achieved higher accuracy rates in authorizations, utilizing attention to detail and organizational skills.
- Coordinated pre-authorization requirements for medical treatments or services, enhancing overall patient experience before appointments.
- Ensured continuity of care for patients by tracking expiring authorizations and initiating renewals as needed.
- Managed high-volume caseloads to meet strict submission deadlines, prioritizing tasks accordingly.
- Reduced claim denials by diligently reviewing and correcting errors in authorization submissions.
- Contributed to revenue growth, securing necessary authorizations for medical procedures promptly and accurately.
- Identified trends in denied claims and implemented proactive measures that resulted in reduced denial rates.
- Maintained comprehensive knowledge of various insurance plans, ensuring accurate information was provided during the authorization process.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Patient Benefit Rep
Texas Oncology
Odessa, TX
01.2018 - 02.2021
- Provided cost estimates of treatments to patients.
- Collected patient payments and setting up payment plans.
- Prepared for patients visit by verifying copays, balances, referrals and authorizations were correctly attached to the correct appointments.
- Verification of insurance eligibility and benefits.
- Provided patients with or without insurance with financial assistance.
- Assisted self-pay patients with the application process for free drug assistance.
- Maintained accuracy of patient’s current insurance by updating any changes.
- Request patient balance adjustments, for movement of credit balances to be applied to balances.
- Corresponded daily to emails.
- Discussed outstanding balances with patients.
- Ensured continuity of care for patients by tracking expiring primary care provider referrals and initiating renewals as needed.
Receptionist
Ghassan N Fanous, MD
Odessa, TX
01.2017 - 04.2018
- Greeted incoming patients and visitors professionally and provided friendly, knowledgeable assistance.
- Answered phone promptly and directed incoming calls.
- Check patients in and out.
- Scheduled patient appointments
- Verification of insurance eligibility and benefits.
- Posting charge tickets and taking patient payments.
- Kept reception area clean and neat to give visitors positive first impression.
Lien Specialist
Resource Corporation of America at Medical Center Hospital
Odessa, TX
01.2015 - 01.2017
- Screening patients involved in motor vehicle collisions.
- Printing and filing hospital liens at the county courthouse.
- Daily follow ups with attorney offices and liability insurances on patient bills.
- Checking for received payments daily.
- Working subpoenas, affidavits and medical billing request.
- Collecting and posting lien payments.
Education
None - General Studies
Odessa College
Odessa, TXDiploma in Medical Office Specialist -
American Commercial College
Odessa, TXDiploma - General Curriculum Studies
Pecos High School
Pecos, TXSkills
- Benefits Administration Expertise
- Customer Service
- Conflict resolution techniques
- Insurance Prior Authorization
- ICD-10 Coding Knowledge
- Strong Communication Skills
- HIPAA Compliance Understanding
- Insurance Verification Expertise
- Teamwork orientation
- Medical Billing Familiarity
- Understanding of insurance details
- Effective communication skills
- Critical thinking abilities
- Retro-Authorizations
- Claim research
- Medical Terminology
- Knowledgeable in EMR
- Teamwork and Collaboration
- Organizing and Prioritizing Work
- Attention to Detail
- Microsoft Office
- Denied claims identification
References
- Melissa Olivas, 432-557-8872
- Monica Jimenez, 915-249-2528
- Melissa Fierro, 432-288-8292
- Amy Daniels, 903-521-8382
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Insurance Authorization Specialist
Texas Oncolgy
02.2021 - Current
Patient Benefit Rep
Texas Oncology
01.2018 - 02.2021
Receptionist
Ghassan N Fanous, MD
01.2017 - 04.2018
Lien Specialist
Resource Corporation of America at Medical Center Hospital
01.2015 - 01.2017
None - General Studies
Odessa College
Diploma in Medical Office Specialist -
American Commercial College
Diploma - General Curriculum Studies
Pecos High School