Summary
Overview
Work History
Education
Skills
Timeline
Generic

Sandra Craddock

Highland Park

Summary

Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

14
14
years of professional experience

Work History

Precertification Specialist

Rutgers Medical School
New Brunswick
10.2018 - Current
  • Reviewed patient documentation for insurance precertification compliance.
  • Coordinated communication between healthcare providers and insurance companies.
  • Managed precertification requests using electronic health record systems.
  • Educated staff on precertification policies and procedures.
  • Assisted patients in understanding their coverage and precertification requirements.
  • Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
  • Reviewed patient medical records to determine medical necessity for requested services and procedures.
  • Maintained detailed documentation of all activities related to the precertification process.
  • Resolved any discrepancies identified during the precertification process.
  • Scheduled tests, lab work or x-rays for patients based on physician orders.
  • Collaborated with insurance companies for pre-authorization of surgical procedures.
  • Verified insurance eligibility and coverage prior to surgery.
  • Scheduled surgical procedures in coordination with physicians and nursing staff.
  • Managed patient communications regarding appointment confirmations and changes.
  • Maintained accurate patient records and updated information in the database.
  • Assisted patients with pre-operative instructions and post-operative follow-ups.
  • Conducted quality assurance reviews on completed records associated with each case.
  • Communicated with patients and family members to provide updates on scheduled dates and times of operations.
  • Provided assistance with post-operative follow up visits when needed.
  • Reviewed daily OR schedule for accuracy before posting it publicly.
  • Used accurate procedure codes for billing purposes and to help operating teams be correctly prepared for each operation.
  • Processed pre-operative orders including lab work, imaging studies and any other required tests prior to surgery date.
  • Coordinated with physicians' offices on scheduling changes or cancellations due to emergency cases or patient cancellations.
  • Managed incoming calls from physicians' offices requesting surgical services.
  • Gathered current medical information and reviewed histories to gather details for surgeons.
  • Transmitted medical records and other correspondence by mail, e-mail, or fax.
  • Organized patient medical records and worked with insurance company representatives to obtain authorization.
  • Routed case confirmations and made schedule updates each day.
  • Scheduled and confirmed patient appointments and consultations.
  • Scheduled appointments using electronic calendar systems for multiple healthcare providers.
  • Managed office workflow by prioritizing appointments based on urgency and availability.
  • Handled incoming calls to address appointment inquiries and resolve scheduling conflicts.
  • Assisted in updating patient records with appointment details and changes.
  • Reviewed patient medical history documents prior to appointment scheduling.
  • Worked collaboratively with other team members to meet departmental goals.
  • Inputted patient data into the electronic health record system.
  • Resolved customer complaints in a professional manner.
  • Served as a liaison between patients and healthcare providers for communication purposes.
  • Coordinated with other departments within the practice to ensure timely patient care.

Clinical Service Representative

Adecco Temp Agency Rutgers Medical School
New Brunswick
12.2017 - 10.2018
  • Maintained accurate patient records in electronic health systems.
  • Coordinated communication between patients and healthcare providers.
  • Managed insurance verification and eligibility checks for patients.
  • Verified patient eligibility for services based on insurance plans
  • Surgical scheduler
  • scheduled Pre admission testing
  • Knowledge of CPT and ICD 10 codes
  • Pre authorized surgical procedures
  • Pre authorized radiology testing
  • Data entry using EMR and IDX
  • Answering heavy phone volume and distribute messages
  • Obtain medical records and radiology imaging disk
  • New patient and post op scheduler
  • schedule transportation

Medical Receptionist

University of Penn Medicine
Monroe
04.2011 - 03.2015
  • Scheduled patient appointments using electronic health record systems.
  • Managed patient check-in and check-out processes efficiently.
  • Verified insurance information and collected co-pays from patients.
  • Assisted healthcare providers by preparing patient charts prior to appointments.
  • Handled phone inquiries regarding appointments and medical services offered.
  • Maintained confidentiality of patient information in compliance with regulations.
  • Coordinated communication between patients and medical staff effectively.
  • Answered incoming calls, responding to inquiries from patients and other medical offices.
  • Pre authorize testing
  • Update bank statements and make bank deposits.
  • secretarial duties

Education

High School Diploma -

Highland Park Highschool
Highland Park, NJ
06-1988

Skills

  • Proficient in Epic
  • Knowledge of CPT and IDC 10 codes
  • Proficient in One Base
  • Medical Terminology
  • Patient Confidentiality
  • Scheduling management
  • Educated with Health insurances
  • Electronic Health records
  • Provider schedule maintenance
  • Time management
  • Data entry
  • Clerical duties

Timeline

Precertification Specialist

Rutgers Medical School
10.2018 - Current

Clinical Service Representative

Adecco Temp Agency Rutgers Medical School
12.2017 - 10.2018

Medical Receptionist

University of Penn Medicine
04.2011 - 03.2015

High School Diploma -

Highland Park Highschool

Similar Profiles

CREATE PROFILE