Patricia Fox
Pittsfield,MA
Summary
Dependable Prior Authorization Specialist with a career spent handling various administrative responsibilities in fast-paced settings. Bilingual individual dedicated to finding solutions to issues and obtaining prior authorization information for patients. Ready to tackle new challenges in an office-based environment.
Overview
31
31
years of professional experience
Work History
Prior Authorization Specialist
Berkshire Medical Center
Pittsfield, MA
04.1994 - 11.2023
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Provided guidance to providers regarding the prior authorization process.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Advised provider offices on proper coding practices that are necessary for successful claim submission.
- Developed relationships with external vendors providing pre-authorization services.
Scheduling Specialist
Berkshire Medical Center Visiting Nurse Association
Pittsfield, MA
06.1992 - 03.1994
- Scheduled appointments for clients and customers, ensuring an appropriate amount of time was allotted for each appointment.
- Created detailed reports on customer service and client satisfaction using data from customer surveys.
- Met regularly with management team to discuss progress towards goals and objectives related to appointment scheduling operations.
- Resolved customer complaints quickly and efficiently while maintaining high levels of professionalism at all times.
Education
GED -
Berkshire Community College
Pittsfield, MA01-1988
Skills
- Process Improvement Strategies
- Insurance Verification
- Workflow Management
- Critical Thinking Abilities
- Insurance Procedures
- Knowledgeable in [Software]
- Medical Coding
- Effective Communication Skills
- Patient Referrals
- Patient Scheduling
- Billing Procedures
Timeline
Prior Authorization Specialist
Berkshire Medical Center
04.1994 - 11.2023
Scheduling Specialist
Berkshire Medical Center Visiting Nurse Association
06.1992 - 03.1994
GED -
Berkshire Community College
Similar Profiles
Olivia GazzilloOlivia Gazzillo
Nursing Assistant at Berkshire Medical CenterNursing Assistant at Berkshire Medical Center
Jessica MurphyJessica Murphy
Nurse at Berkshire Medical CenterNurse at Berkshire Medical Center
Michael M KuehlMichael M Kuehl
Supervisor of Engineering and Facility's at Berkshire Medical CenterSupervisor of Engineering and Facility's at Berkshire Medical Center
Kurtis BaronoskiKurtis Baronoski
Sterile Processing Technician at Berkshire Medical CenterSterile Processing Technician at Berkshire Medical Center
Kevin SoucyKevin Soucy
Ramp Transport Driver at FedEx ExpressRamp Transport Driver at FedEx Express