Natira Richardson
Houston,TX
Summary
Knowledgeable Insurance Verifier/Prior Authorization Rep with solid background in verifying insurance information and ensuring accuracy in patient records. Successfully facilitated seamless communication between patients, healthcare providers, and insurance companies. Demonstrated attention to detail and problem-solving skills in resolving coverage issues and discrepancies.
Overview
8
8
years of professional experience
Work History
Senior Insurance Verifier
Houston Methodist Hospital
Houston, TX
06.2022 - 03.2026
- Utilized telephone and internet resources to confirm insurance eligibility for patients prior to scheduled appointments.
- Assessed and confirmed benefits for scheduled patients, supporting overall patient care and satisfaction.
- Engaged with physician offices to retrieve critical patient information, ensuring seamless coordination between insurance verification and scheduling functions.
- Managed the timely completion of prior authorization requests to support patient care initiatives.
- Executed timely submission of requested medical documentation to ensure compliance with insurance requirements.
- Coordinated efforts with insurance providers to ensure timely pre-authorization and re-authorization of patient services.
- Facilitated communication regarding authorization status and necessary documentation to ensure compliance.
- Updated practice management system with current authorizations to ensure compliance and efficiency.
- Addressed internal and external inquiries regarding authorization processes.
- Conducted thorough follow-ups on insurance authorizations to facilitate patient care and service delivery.
- Engaged with healthcare providers to ensure accurate understanding of patient information and documentation necessities.
Prior Authorization Representative
Healthsource Medical Response
Houston, TX
01.2021 - 03.2022
- Assessed and confirmed insurance eligibility for ambulance transport to ensure compliance with protocols.
- Coordinated and submitted prior authorization requests to optimize transport logistics.
- Managed communication through inbound and outbound calls to monitor and report on request statuses.
- Coordinated follow-up efforts with facilities to secure payment for overdue invoices and uphold cash flow integrity.
- Collaborated with billing team to prepare and submit appeals, enhancing efficiency in claim resolutions.
- Analyzed patient medical records and insurance details to ensure compliance with approval criteria.
- Collaborated with referring physicians to ensure comprehensive information collection for effective case management.
- Maintained up-to-date patient information by systematically entering and updating records in the database.
- Monitored scheduling processes to ensure timely resolution of emerging challenges.
- Reviewed and finalized billing documentation to support efficient financial operations.
- Supported administrative functions by executing additional clerical responsibilities as required.
Medical Records Rep
Medical plus supplies
05.2018 - 09.2020
- Collected and verified documentation from healthcare providers to ensure patients receive necessary medical supplies.
- Executed customer service strategies to enhance client satisfaction.
- Provided assistance to patients and doctor offices by answering inquiries about medical record requests and processes.
- Performed diagnosis coding to support efficient distribution of necessary medical supplies.
- Conducted verification of medical insurance coverage to facilitate payment processing for necessary supplies.
- Organized and converted patient charts and documents into digital files to facilitate efficient paperwork management.
- Constructed detailed spreadsheets to facilitate accurate and timely input of patient paperwork for healthcare providers.
- Managed logistics for timely pickup and delivery of essential equipment and supplies to patient residences.
- Coordinated with insurance providers to acquire required authorizations for medical services.
Medical Coding and Billing Specialist
Busy Bee Wellness
03.2018 - 05.2018
- Reviewed patient records to verify suitability and correctness of health information for clinical decision-making.
- Documented data electronically to streamline collection, storage, analysis, recovery, and reporting processes.
- Maintained accurate and up-to-date information in medical databases and registries to support healthcare operations.
- Processed a wide range of insurance claims to ensure timely resolution and customer satisfaction.
- Executed classification software to accurately assign clinical codes for reimbursement processes.
- Monitored and secured patient health information, maintaining adherence to privacy regulations.
- Executed comprehensive preparation, data entry, and proofreading of health check records to maintain high standards of documentation.
Education
Certificate - Medical Coding and Billing-HIM
College of Healthcare Profession
Houston, TX05-2018
Certificate - Medical Assisting
National Institute of Technology
Houston, TX02-2002
High School Diploma -
Evan E. Worthing Senior High
Houston05-1998
Skills
- Customer service experience
- HIPAA compliance
- Insurance verification
- Follow-up skills
- Healthcare regulations
- Insurance authorizations
- Patient registration
- Computer proficiency
- Patient scheduling
- Electronic health records
- Detail-oriented
- Verbal and written communication
- Adaptability and flexibility
- Electronic authorization processing
- Referral coordination
- Proficient in EPIC, Availity, Novitasphere, TMHP, AngelTrack, INSCRYBE, Rhyme, Change Healthcare
- Prior authorization processing
- Medical terminology
Timeline
Senior Insurance Verifier
Houston Methodist Hospital
06.2022 - 03.2026
Prior Authorization Representative
Healthsource Medical Response
01.2021 - 03.2022
Medical Records Rep
Medical plus supplies
05.2018 - 09.2020
Medical Coding and Billing Specialist
Busy Bee Wellness
03.2018 - 05.2018
Certificate - Medical Coding and Billing-HIM
College of Healthcare Profession
Certificate - Medical Assisting
National Institute of Technology
High School Diploma -
Evan E. Worthing Senior High