Sabrina E. Maracallo

• Responsible for the coordination of prior-authorizations, pre-certification, and referral process for patients referred to specialty care, diagnostic procedures, hospital admissions and surgical services
• Process authorizations for accuracy and compliance with government regulations via phone or payor portals while ensuring authorization request has completed clinicals to prove medical necessity
• Ensure notification of reimbursement to physicians, nurses, financial clearance staff, and patients prior to services rendered
• Update referral and document authorization process and outcome with authorization numbers and reference numbers issued by payor
• Continuously review payor medical policy guidelines to manage authorizations effectively
• Daily contact with a broad spectrum of staff throughout the organization including management, clinical staff, front line associates and outside agencies/institutions
• File written appeals for authorization denials and/or schedule peer to peer for reconsideration of authorizations

• Responsible for overseeing, assisting and training of staff when needed
• Ensured the effective management of all incoming referrals, authorizations, pre-registration, and scheduling including the transition of inquiries to the appropriate service lines
• Responsible for completing/distributing paperwork, answered incoming calls, entered demographic information, verified eligibility, identified out of pocket costs, and communicated with patients on point of cash requirements on or before service date
• Resolved patient billing issues in line with established guidelines
• Facilitated communication between patients and various departments and staff
• Trained new staff on hospital processes and procedures

Patient Access Liaison

(Admitting/Outpatient/Emergency Department)

• Responsible for overseeing staff as charge liaison and assisted in all areas when patient flow demanded
• Expedited placement of beds for admitted patients from the emergency department or direct admissions called in from a Physician’s office
• Assigned, transferred, discharged patients according to diagnosis on appropriate floors and all hospital areas
• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
• Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations
• Trained new staff on hospital processes and procedures