MERRY FULLER
Broken Arrow
Summary
Experienced professional with a background in healthcare and hospitality. Highly skilled in customer service, patient advocacy, administrative support, financial services, and regulatory compliance. In my next role, I am eager to contribute my skills and experience.
Overview
7
7
years of professional experience
Work History
Insurance Authorization Specialist
Trinity Health
07.2024 - Current
- Ensuring patients are covered for the services they need and verifying their insurance information
- Verifies patient information with third party payers
- Collects insurance referrals and documents within HIS
- Communicates with patients and physician/offices regarding authorization/referral requirements
- Identifies potential need for financial responsibility forms or completed electronic forms with patients as necessary
- Escalates accounts appropriately in accordance with department Defer/Delay policy to manager
- Documenting authorization requests, approvals, and denials in patient records
- Adhering to insurance company guidelines and regulations regarding authorization processes
Authorization Specialist
Hillcrest Medical Center
08.2021 - 01.2024
- Proficient in obtaining pre-authorizations for medical procedures, tests, and treatments from insurance companies, ensuring timely approval and reimbursement
- Skilled in navigating insurance policies, verifying coverage, and communicating with payers to resolve authorization-related issues
- Experienced in maintaining accurate documentation of authorization requests, approvals, and denials, in compliance with regulatory guidelines
- Collaborate with healthcare providers, patients, and insurance representatives
- Knowledgeable about medical terminology, diagnosis codes, and procedural codes to accurately complete authorization requests and appeals
Patient Services Representative
Saint Francis Healthcare Systems
08.2018 - 08.2021
- Managed patient information using various office software applications while adhering to strict HIPAA regulations
- Provided comprehensive support to hospital and clinic operations by leveraging strong customer service skills and detailed system knowledge
- Verified insurance coverage and confirmed patient appointments by checking provider schedules
- Handled credit card transactions and ensured accurate deposit balancing on a daily basis
- Acted as a liaison between patients and healthcare professionals to address patient needs efficiently
- Addressed patient inquiries, concerns, and complaints promptly and professionally
- Coordinated patient appointments with healthcare professionals and communicated payment plan agreements after verifying patient eligibility and benefits with insurance companies
Education
High School Diploma -
Okmulgee High School
Okmulgee05.2015
Skills
- Medical Billing and Terminology
- Electronic Health Records (EHR)
- Healthcare Industry Knowledge
- Health Insurance Verification
- Financial Counseling
- HIPAA and PHI Confidentiality
- Data Entry and Documentation
Timeline
Insurance Authorization Specialist
Trinity Health
07.2024 - Current
Authorization Specialist
Hillcrest Medical Center
08.2021 - 01.2024
Patient Services Representative
Saint Francis Healthcare Systems
08.2018 - 08.2021
High School Diploma -
Okmulgee High School
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