Paula Russell

Daily Task:

Verify all coverages, and benefits, note and attach all benefits to each appointment. Submit and obtain all authorizations if required. Extensive knowledge of authorization requirements for each carrier is necessary.

I work diligently to ensure that procedures are properly authorized, ensure claims are not rejected, and the company will be fully reimbursed. This includes verifying that each CPT code is supported by an appropriate payable diagnosis code and appropriate clinicals are available.

• Self-motivated, problem solving independent.
• Promoted high customer satisfaction by coordinating pretesting and educating Insurance benefits.
• Utilize daily various software's: access to all payer portals, and authorization sites. Notable understanding of benefit interpretations.
• Resolved discrepancies with auth, and submitted appeals, when denials were given.
• Coordinated with MDs, Medical director, nursing staff, billing, and claims dept; also necessary in this role.
• Responsible for all outside facility Diag auths. Also, send orders and records to outside sites. Managed fax inbox for diagnostic dept and answered all telephone message requests. Supported appointment scheduling, Stat requests, and cost requests.
• Responsible for ensuring the daily schedule is fully booked, MRI, CT and 2 Ultrasound schedules.

Greeted, verified, obtained all demographics, collected payments and scheduled follow-up appointments with accuracy and professionalism. Utilized Cerner EMR.