Sara Twigg-Bingham
Lynnwood,WA
Summary
Dynamic customer service representative with 23 years of experience in healthcare settings. Expertise in problem-solving, communication, and process improvement. Committed to enhancing patient satisfaction and streamlining operations.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Customer Service Representative
Virginia Mason
Edmonds, Washington
01.2001 - 11.2024
- Assisted patients with scheduling appointments and managing inquiries.
- Responded to customer concerns promptly and effectively via phone and email.
- Collaborated with healthcare teams to ensure patient information accuracy.
- Provided support during busy periods to enhance service delivery efficiency.
- Trained new staff on customer service protocols and best practices effectively.
- Answered customer inquiries and provided accurate information regarding products and services.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- Tracked orders from start to finish to ensure timely delivery of goods or services.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Identified areas of improvement in customer service processes and suggested changes accordingly.
- Developed positive relationships with customers through friendly interactions.
- Provided exceptional customer service to ensure customer satisfaction.
- Resolved customer complaints promptly and efficiently.
- Identified opportunities for upselling additional products or services based on customer needs.
- Implemented innovative methods for streamlining the customer service process.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
Referral & Prior Authorization Coordinator
Virginia Mason
Edmonds, Washington
05.2018 - 10.2024
- Executed daily duties with precision and efficiency.
- Managed prior authorization requests for medical services and procedures.
- Reviewed patient documentation for compliance with insurance standards.
- Identified customer needs to ensure timely responses.
- Delivered exceptional customer service in person and via phone.
- Collaborated with coworkers to address product-related issues effectively.
- Organized and prioritized tasks to achieve service goals.
- Maintained current knowledge through continuous education and training.
- Managed prior authorization requests for various medical services and procedures.
- Reviewed patient documentation to ensure compliance with insurance requirements.
- Updated electronic health records with authorization statuses and relevant information.
- Educated staff on prior authorization policies and procedures at Virginia Mason.
- Assisted patients in understanding their insurance coverage and authorization processes.
- Process prior authorization requests for medical services and procedures.
- Review patient medical records to verify eligibility and coverage.
- Communicate with healthcare providers to gather necessary documentation.
- Maintain accurate records of authorization requests and outcomes.
- Coordinate with insurance companies to resolve authorization issues.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Maintained a professional attitude when interacting with external customers such as physicians' offices or insurance companies.
- Utilize electronic health record systems to track authorization status.
- Educate patients about prior authorization requirements and timelines.
- Collaborate with clinical teams to ensure compliance with policies.
- Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Notified ordering providers of denied authorizations.
- Coordinated resolutions for issues and appealed denied authorizations.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Maintained files for referral and insurance information, entering referrals into system.
- Collaborated with internal departments to provide account status updates.
- Scheduled patient appointments, diagnostic specialty appointments, tests and procedures.
- Clarified patient inquiries and questions to update patient account information in computer system.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Compiled data from multiple sources for reporting purposes.
- Researched payer coverage policies, procedures, and requirements.
- Collaborated with providers to obtain missing information required for authorization submissions.
- Determined medical necessity of requested services by reviewing patient records and corresponding with providers as needed.
- Facilitated resolution between providers, payers, patients, and internal staff on matters related to prior authorizations.
- Communicated effectively both verbally and in writing with various levels of staff across the organization.
- Analyzed denied claims in order to identify potential issues that could be addressed proactively.
- Identified discrepancies in submitted documents or coding errors that may affect payment or reimbursement.
- Provided customer service support by responding promptly to provider inquiries regarding authorization status or policy information.
- Ensured compliance with all applicable federal, state, local laws, rules and regulations pertaining to the area of responsibility.
- Created and maintained accurate documentation for all prior authorization activities.
- Assisted with appeals process when necessary.
- Developed strategies for streamlining workflow and improving efficiency in the department.
- Reviewed and processed prior authorization requests according to insurance guidelines.
- Maintained up-to-date knowledge of healthcare reimbursement policies, regulations, and industry trends.
- Processed high volume of requests within established turnaround times while maintaining quality standards.
- Performed daily audits to ensure accuracy of prior authorization processes.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Input claim, prior authorization, and other important medical data into system.
- Reviewed and processed prior authorization requests for medical procedures and medications according to established guidelines.
- Determined which party would be liable for payment on medical services by thoroughly reviewing patient insurance coverage.
- Maintained accurate and up-to-date records of authorization requests and outcomes in electronic health record systems.
- Conducted regular audits of authorization records to ensure compliance with regulatory standards.
- Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.
- Coordinated with pharmacy staff to ensure medications requiring prior authorization are processed correctly.
- Coordinated with healthcare providers to gather necessary patient information for prior authorization requests.
- Communicated authorization decisions, including approvals and denials, to healthcare providers and patients.
- Trained new staff on prior authorization procedures and company policies.
- Assisted in the development of educational materials for patients about the prior authorization process and insurance benefits.
- Evaluated patient eligibility and benefits for requested procedures and medications.
- Negotiated with drug manufacturers and insurance providers to obtain coverage for off-label or non-formulary medications.
- Developed and implemented process improvements to enhance efficiency and accuracy of prior authorization workflows.
- Utilized medical coding knowledge to accurately process and document authorization requests.
- Followed up on pending prior authorization requests to ensure timely processing.
- Participated in multidisciplinary team meetings to discuss complex cases requiring prior authorization.
- Educated healthcare providers on prior authorization requirements and insurance formulary changes.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Communicated with patients with compassion while keeping medical information private.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
- Greeted patients, determined purpose of visit and directed to appropriate staff.
- Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
- Completed relevant insurance and other claim forms.
- Arranged hospital admissions for patients as required.
Business Office Assistant
Virginia Mason
Edmonds, Washington
07.2005 - 05.2018
- Coordinated scheduling for appointments, meetings, and office events.
- Assisted with the on boarding of new staff members and training support.
- Handled customer inquiries and resolved issues promptly and professionally.
- Supported data entry tasks into internal systems for record keeping accuracy.
- Responded promptly to inquiries from vendors regarding pa
- Maintained customer databases and generated monthly sales reports.
- Operated office equipment, such as copy machine, scanner and printer.
- Organized vendor contracts for review by senior management.
- Researched billing disputes and provided solutions to resolve customer complaints.
- Processed incoming payments from customers using a variety of payment methods.
- Ensured compliance with company policies regarding inventory control procedures.
- Maintained positive working relationship with fellow staff and management.
- Managed accounts receivable and payable activities, including preparing invoices and reconciling payments.
- Collaborated with team members to improve workflow processes within the office.
- Answered phone and routed calls to appropriate team members.
- Resolved customer complaints in a professional manner while adhering to company policies.
- Ordered office supplies for supply closet inventory.
- Tracked project costs against budget projections on a regular basis.
- Determined consumer needs to provide products and services appealing to larger market.
- Audited company's legal documents to verify compliant policies and procedures.
- Wrote and submitted reports on industry trends, prompting managers to develop business plans.
- Managed patient scheduling and appointment coordination for efficient office operations.
- Processed patient records and maintained confidentiality in compliance with regulations.
- Supported administrative tasks, including filing, data entry, and document preparation.
- Communicated effectively with patients and staff to address inquiries and concerns.
- Collaborated with healthcare providers to streamline office workflows and processes.
- Answered multi-line phone system and accurately routed calls to correct individuals.
- Organized paper filing system to maintain accurate records.
- Resolved customer complaints in a professional manner.
- Accepted and processed payments from customers in person and over telephone.
- Provided administrative support to the finance department staff as needed.
- Communicated with vendors to resolve any invoice discrepancies or payment issues.
- Maintained customer account records by updating information such as contact details, payment history and credit limits.
- Greeted visitors with friendly and professional demeanor and provided direction to appropriate party.
- Inputted data into QuickBooks software system for bookkeeping purposes.
- Assisted with billing inquiries and verified insurance information for accuracy.
- '\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\z
- Handled incoming calls and inquiries, directing them to appropriate departments.
- Provided administrative support to medical staff, enhancing office efficiency.
OB Coodinator
Virginia Mason
Edmonds, Washington
03.2005 - 05.2018
- Coordinated project schedules and timelines for various departmental initiatives.
- Assisted in developing and implementing operational policies and procedures.
- Managed communication between teams to ensure alignment on project goals.
- Supported event planning by organizing logistics and coordinating resources.
- Maintained documentation for projects, ensuring accuracy and accessibility.
- Collaborated with cross-functional teams to streamline processes and improve efficiency.
- Resolved customer complaints in a timely manner while upholding company standards.
- Ensured compliance with company policies and procedures related to project management activities.
- Recommended solutions related to staffing issues and proposed procedural changes to managers.
- Created and maintained accurate records of departmental activities, including budgets, personnel documents and project timelines.
- Analyzed financial activities of department to share budgetary input with managers.
- Computed balances, totals or commissions to support accounting team.
- Implemented departmental policies and standards in conjunction with management to streamline internal processes.
- Reviewed employees' work to check adherence to quality standards and proper procedures.
- Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Delegated work to staff, setting priorities and goals.
- Guided employees in handling difficult or complex problems.
Education
High School Diploma -
Mariner High School
Everett, WA06-1992
Skills
- Prior authorization management
- Medical billing compliance
- Patient eligibility verification
- Electronic health records management
- Insurance documentation analysis
- Customer relationship management
Certification
I attended Phlebotomy Training Specialists Medical School.
I have received mu Medical Assistant - Phlebotomy Certification. Issue date 08/05//2025. Credential# PC70004389
Timeline
Referral & Prior Authorization Coordinator
Virginia Mason
05.2018 - 10.2024
Business Office Assistant
Virginia Mason
07.2005 - 05.2018
OB Coodinator
Virginia Mason
03.2005 - 05.2018
Customer Service Representative
Virginia Mason
01.2001 - 11.2024
High School Diploma -
Mariner High School
Similar Profiles
Gail GomezGail Gomez
Registered Nurse at Virginia Mason/Virginia Mason Fransican HealthRegistered Nurse at Virginia Mason/Virginia Mason Fransican Health
Megan WilsonMegan Wilson
Registered Nurse Short Stay Procedural at Virginia MasonRegistered Nurse Short Stay Procedural at Virginia Mason
Debra FurulieDebra Furulie
Customer Service Representative at Virginia MasonCustomer Service Representative at Virginia Mason
Dang HoangDang Hoang
Medical Assistant at Virginia MasonMedical Assistant at Virginia Mason
Juan TrujilloJuan Trujillo
Maintenance Supervisor at Punch ItMaintenance Supervisor at Punch It