Robin Reid

• Reviewed accounts for insurance of patient follow-
• Worked closely with delinquent account holders to collect and reconcile accounts through approved channels.
• Accepted and processed customer payments and applied toward account balances.
• Routinely contacted account holders with balances over 30, 60, & 90 days past due to resolve delinquencies.
• Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
• Interfaced with customers to bring accounts current with suitable repayment plans.
• Improved profit margins by streamlining operations and workflow.
• Juggled multiple projects and tasks to ensure high quality and timely delivery.
• Provided excellent service and attention to customers when face-to-face or through phone conversations.
• Verified eligibility and compliance with authorization requirements for service providers.
• Tracked referral submission during facilitation of prior authorization issuance.
• Processed unscheduled and emergency authorizations, directing submissions to appropriate personnel for rapid response.
• Enhanced team productivity with thorough training of new staff members on company policies and procedures.
• Maintained patient confidentiality and safeguarded medical records to avoid information breaches.
• Increased accuracy of insurance coverage validation by utilizing available tools and resources to verify eligibility requirements quickly.
• Fielded telephone inquiries on authorization details from plan members and medical staff.
• Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
• Demonstrated adaptability by managing multiple priorities simultaneously, ensuring all tasks were completed accurately and on time.
• Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
• Resolved patient billing inquiries and other issues efficiently.
• Participated in ongoing professional development opportunities to stay current on best practices within the field of prior authorization services.
• Collaborated with healthcare providers to expedite process of obtaining necessary medical documentation for approvals.
• Contacted insurance companies to obtain prior authorization for medical procedures.
• Delivered consistent high-quality work under pressure, effectively managing high caseloads while meeting deadlines set forth by payers or internal guidelines.

Demonstrated strong problem-solving skills to resolve complex insurance issues, resulting in a decrease in claim denials by 20%.
• Maintained excellent customer service skills and professional telephone etiquette, resulting in a patient satisfaction rating of 95%.
• Utilized time management, organizational skills, and the ability to multitask to manage a high volume of insurance verifications, resulting in a 15% increase in productivity.
• Reviewed medical documents and patient information to ensure insurance documentation is correct, resulting in a reduction in billing errors by 10%.
• Maintained regular communication and follow-up with program and department contacts regarding pending insurance, coverage, and other payment-related issues, resulting in a decrease in payment delays by 25%.
• Worked independently to meet objectives, achieving a 95% accuracy rate in data entry and a 98% on-time completion rate of assigned tasks.

• Created and maintained accurate and confidential patient files according to regulatory mandates.
• Updated patient financial information to promote accurate record keeping.
• Established databases to track, analyze and automate eligibility application processes.
• Trained staff on current eligibility requirements and policies.
• Engaged wider departments in accurate, timely paperwork completion.
• Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.

Determine If re-authorization needed for new order.
Verify Medicaid eligibility.
Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
Retained strong medical terminology understanding in effort to better comprehend procedures.
Followed specific security rules and guidelines to protect sensitive data, including patient medical records and payment card information.
Signed payment approvals accepted claims.
Updated all patient and insurance data regularly and carefully inputted changes into company's computer system.
Handled billing related activities focused on medical specialties.
Examined claims, records and procedures to grant approval of coverage.
Checked documentation for appropriate coding, catching errors and making revisions.
Verified that patients had proper insurance coverage prior to any procedures or appointment scheduling.