Reliable professional offering an extensive career in positive customer experiences within different clinical settings. Dedicated, adaptable employee with a proactive attitude, and the ability to learn quickly. Strong work ethic and effective communication skills.
Overview
5
5
years of professional experience
Work History
Prior Authorization Specialist
Great Lakes Medical Imaging
Williamsville
01.2025 - Current
Verified patient insurance coverage, including eligibility, benefits, and authorization requirements for medical services.
Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
Answered several medical questions regarding a patient's current symptoms and history to ensure clinical criteria is met.
Notified ordering providers of denied authorizations and the steps to appeal, including scheduling peer-to-peer discussions.
Scheduler
Great Lakes Medical Imaging
Williamsville
05.2023 - 01.2025
Answered incoming calls from patients and physician offices to schedule diagnostic imaging exams.
Collected demographic information and insurance from patients.
Maintained communication with several physicians' offices via MEDENT and phone regarding patient information.
Completed pre-screening questionnaires with patients to ensure their machine compatibility and medical history are compliant with scheduling guidelines.
Confirmed patients are scheduled for the correct CPT codes, that their diagnosis codes are correct, and that their bloodwork levels are within the range to be safely scanned.
COVID-19 Case Investigator
Public Consulting Group on behalf of NYSDOH
Remote
08.2021 - 03.2022
Conducted interviews to gather information from COVID-19 positive individuals.
Documented case details accurately in electronic health record systems.
Explained quarantine procedures to ensure compliance with health guidelines.
Collaborated with public health officials to identify potential exposure sites.
Provided resources and support for individuals facing isolation challenges.
Identified areas where additional support was needed in order to ensure that proper safety protocols were being followed by both healthcare providers and members of the general public alike.
Maintained up-to-date records of all cases investigated including documentation of contact tracing activities, interviews conducted, and any follow up actions taken.
COVID-19 Contact Tracer
Public Consulting Group on behalf of NYSDOH
Remote
11.2020 - 08.2021
Conducted interviews with individuals to gather accurate contact information.
Monitored and tracked reported cases of exposure to ensure timely follow-up.
Educated individuals on quarantine protocols and health guidelines for safety.
Documented interactions in a database to maintain accurate records and reporting.
Engaged in active listening techniques while interviewing contacts in order to provide support throughout the process.
Adhered strictly to privacy laws and regulations when collecting personal information from contacts during case investigations.
Education
Associate of Science - Social Sciences
Erie Community College
Buffalo, NY
01-2023
High School Diploma -
Nardin Academy
Buffalo, NY
06-2019
Skills
CPT coding
Problem solving
Attention to detail
Insurance verification
Medical terminology
Conflict resolution
Active listening
Effective communication
Fast typing speed
Accurate message transcription
Call transferring
Telephone etiquette
Strong interpersonal skills
Switchboard operation
Proficient in MEDENT, G Suite, Microsoft Excel, EIS, EClinicalWorks, Nextiva, Amazon Connect, Availity, Evolent, Evicore, and Healthelink