Melissa Rodriguez Laurenzana

• Coordinate specialty clinic referrals and appointments, assisting patients and families with navigating departments, services, and healthcare resources.
• Complete pre-screening and insurance verification processes for specialty clinic appointments requiring referrals and prior authorization.
• Verify patient insurance eligibility, benefits, coverage requirements, and authorization criteria to support timely access to care.
• Review medical records and abstract relevant chart information to assign CPT, ICD, and HCPCS codes for predetermination and prior authorization purposes.
• Serve as a liaison between patients, providers, clinic staff, insurance companies, and other payors to coordinate financial benefits, coverage, referrals, and authorization requirements.
• Prepare, complete, and submit medical documentation, referral information, and supporting paperwork to insurance companies and other payors for authorization and coverage determination.
• Document approved prior authorizations and related financial information accurately in electronic healthcare and financial systems.
• Coordinate with hospital departments, clinic staff, surgical representatives, providers, and other healthcare teams regarding day-surgery authorizations, financial coverage, and assistance programs.
• Assist self-pay patients by identifying available financial assistance resources and coordinating financial assistance appointments.
• Monitor and investigate payment denials related to missing or incorrect authorizations and communicate findings to supervisors and billing representatives to support appeal efforts.
• Obtain and coordinate prior medical records, billing information, referrals, laboratory results, and other documentation required for patient care and insurance processing.
• Assist referring providers with resolving referral and authorization issues, locating appropriate physicians, and forwarding necessary medical documentation.
• Identify patients' primary care providers and communicate with physician offices and healthcare teams as needed to support continuity of care.
• Provide professional customer service to patients, families, providers, insurance representatives, and internal departments while handling sensitive and confidential information.
• Provide training and outreach to clinical areas regarding referral and authorization processes to promote efficient workflow, accuracy, and communication.
• Assist clinical staff with routine non-invasive procedures and initial patient screenings as permitted by departmental protocols and training.
• May provide functional and technical guidance to lower-level staff and assist with maintaining efficient departmental operations.
• Follow patient safety policies, procedures, and protocols while proactively identifying opportunities to improve safety and quality of care.
• Identify and report environmental hazards, patient safety concerns, medical errors, and near misses in accordance with established procedures.
• Encourage patients to actively participate in their care by providing clear information and encouraging them to ask questions and communicate concerns.
• Promote patient-centered care by maintaining respectful, responsive, and effective communication with patients, families, providers, and healthcare teams.

• Provide professional and compassionate customer service to patients, families, visitors, and healthcare staff in an ambulatory healthcare setting.
• Serve as the first point of contact for patients and visitors by identifying their needs, providing assistance, and directing them to the appropriate department or service.
• Assist patients and families with admission and discharge processes while answering questions and helping resolve concerns.
• Register patients by obtaining and verifying demographic, financial, and insurance information and collecting required signatures and documentation.
• Schedule new and follow-up appointments, tests, and other medical services according to department procedures.
• Verify insurance eligibility, coverage, referrals, prior authorizations, restrictions, and financial information as required.
• Accurately enter, review, and update patient information and other data in electronic systems while maintaining confidentiality and accuracy.
• Perform basic cashiering duties, including collecting payments, processing transactions, and balancing the cash register.
• Answer incoming telephone calls, provide information, direct calls to the appropriate department or staff member, and accurately relay messages.
• Provide clear and courteous communication while maintaining a high level of customer satisfaction and service.
• Assist with patient discharge activities, including coordinating referrals, scheduling tests, and completing related administrative tasks.
• Collaborate with healthcare teams and assist other departments or clinics as needed to support efficient daily operations.
• Follow hospital and departmental policies, procedures, privacy standards, and patient-centered service expectations.
• Promote a patient-centered approach by treating every patient and family member with respect, professionalism, empathy, and courtesy.

• Data Entry, greeting clients, and answering multi-line phone systems.
• Communicating with client via phone, email and in person.
• Coordinating appointments, and meetings.
• Generating and reviewing monthly and quarterly reports.
• Reviewing, modifying, counseling, and filing of loan paperwork.
• Package USDA Rural Development 502 home loans.