Athena Net
Myra Barra
Experienced Referral & Insurance Verification Specialist
Madera,CA
Summary
A detailed-oriented, professional, passionate about problem solving, coordinating services and resources for clients. I strive to join an organization committed to high quality customer care. Tenacious Referral & Insurance Specialist with over 15 years connecting clients with medical providers. Successful working with insurance companies and other medical professionals to obtain prior authorization and set up essential client appointments. Applies proactive approach to problem-solving and resourceful use of industry network.
Overview
15
15
years of professional experience
2
2
years of post-secondary education
1
1
Language
Work History
Medical Referral Specialist
United Health Centers
Fresno, CA
03.2021 - Current
- Responsible for complex referrals (i.e. limited insurance coverage, rare diagnosis, extensive travel requirements, etc.)
- Manage heavy flow of incoming calls from patients, specialist offices and insurance companies.
- Coordinate outpatient testing and specialist referrals generated by multiple health center providers within established service time goals.
- Established rapport and communication with patients and specialty offices to inquire and verify existing referral appointments.
- Assisted patients in locating resources that accepted various insurances.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Determined appropriateness of payers to protect organization and minimize risk.
- Reviewed 40-50 patient cases per day and verified insurance coverage information.
- Observed strict procedures to protect sensitive patient information, medical records and payment data.
- Verified client information by analyzing existing evidence on file.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
Front Office Administrative Assistant
Madera Community Hospital
Madera, CA
08.2016 - 02.2021
- Directly responsible for centralized administration, patient records, scheduling and operations of busy medical office.
- Answer and operate muli-line phone.
- Maintenance of accurate patient records within HIPAA guidelines
- Verify health insurance eligibility and complete pre-authorizations for services and medications.
Medical Assistant
Sanjay J. Chauhan MD Inc.
Fresno, CA
12.2006 - 05.2016
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Prepared initial patient charts for admission.
- Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
- Performed clerical duties, such as word processing, data entry, answering phones and filing. Acquired insurance authorization for treatment.
Education
Associate of Applied Science - Medical Assisting
Heald College
Fresno 07.2003 - 04.2005
Skills
Self starter
undefinedSoftware
Valer
EPIC
MediSoft
ECW
Medi-Cal Website
Most insurance portals
Timeline
Medical Referral Specialist
United Health Centers
03.2021 - Current
Front Office Administrative Assistant
Madera Community Hospital
08.2016 - 02.2021
Medical Assistant
Sanjay J. Chauhan MD Inc.
12.2006 - 05.2016
Associate of Applied Science - Medical Assisting
Heald College
07.2003 - 04.2005
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