SARIANG BRENDA DELKUU
Burien,WA
Summary
Dedicated healthcare professional focused on enhancing customer satisfaction through exceptional service and support. Expertise in managing complex authorization processes ensures compliance and efficiency. Strong problem-solving skills streamline workflows and elevate patient experiences. Recognized for effective collaboration and adaptability in fast-paced environments, consistently delivering results while maintaining meticulous records. Organized and reliable, adept at juggling multiple priorities with a positive attitude, ready to embrace additional responsibilities to achieve team objectives and drive organizational success.
Overview
33
33
years of professional experience
Work History
Referral and Authorization Specialis
Providence Swedish Medical Center
Seattle, WA
11.2022 - Current
- Processed patient authorizations efficiently, ensuring compliance with health regulations and protocols.
- Collaborated with healthcare providers to verify eligibility and resolve authorization issues promptly.
- Utilized electronic health record systems to track and manage authorization requests effectively.
- Developed training materials for staff on best practices in authorization procedures and system usage.
- Led initiatives to streamline authorization workflows, reducing processing times significantly.
- Analyzed authorization trends to identify areas for improvement and implement strategic changes.
- Coordinated cross-departmental communication to ensure timely resolution of authorization-related inquiries.
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
- Developed strong relationships with insurance representatives to expedite approvals and resolve issues promptly.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
- Improved patient satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Resolved discrepancies with client applications to verify eligibility.
- Promoted positive customer experiences by addressing concerns or questions related to authorizations in a professional manner.
- Analyzed and verified patient insurance eligibility, enhancing approval accuracy for procedures.
- Coordinated authorization processes for patient services, ensuring compliance with regulatory guidelines.
- Mentored junior team members on authorization protocols, fostering a collaborative work environment.
- Streamlined communication between clinical staff and insurance providers to expedite service delivery.
- Collaborated with interdisciplinary teams to resolve complex authorization issues, promoting patient access to care.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
ADMINISTRATION ASSISTANT
ITS CONGLOBAL INDUSTRIES
11.2018 - 11.2022
- Coordinate depot inventories to achieve customer’s goals, Foster productive relationships with customers by phone or email, Monitor, process and invoice maintenance and services performed, developing solutions to complex problems in timely manner, and maintain accurate records and backup documentations.
FRONT OFFICE SUPERVISOR / PATIENT REGISTRAR
US HEALTH WORKS MEDICAL GROUP
08.2007 - 03.2018
- Perform all clerical duty to accommodate all needs from the billing office and around the whole clinic to maintain the satisfactions of patients, clients and co-workers, batching, processing, coding, and analyzing patients’ records. To orchestrate a smooth transition between front office and Doctors, oversee the entire patient’s visit from entering the clinic to the end of the visit to make sure all patient’s needs are fulfilled.
PATIENT COORDINATOR / MEDICAL RECORD CLERK III / NUTRITION DIET CLERK
SWEDISH MEDICAL CENTER FIRST HILL CANCER INSTITUTE
09.1992 - 01.2007
- Perform all clerical duties to ensure patient’s needs, analyze patients reports for billing, registrar, scheduling and confirm appointments, assist technicians with patients, answer phones, filing, faxing, process record requests. Reception, manage patient’s information, input record documents in data base, manage requests for patient’s medical records from outside sources (ROI) Managing patient’s dietary order from doctors, verify records with dieticians and update in data system, processing requisitions per Doctor’s order.
Education
AA Business Administration -
Bellevue Community College
Certificate - Data Processing and Data Entry
ITT Technical Institute
Certificate - Patient Billing and Coding
Renton Technical College
Skills
- Customer service excellence
- Proficient in medical terminology
- Proficient data entry
- HIPAA compliance
- Prior authorization processing
- Skilled in applying medical coding standards
- Structured document arrangement
- Proficient in Microsoft Office
- Effective communication skills
- Policy interpretation
- Interviewing
- Resource information
- Verbal communication
- Data entry
- Record keeping
- Telephone etiquette
- Confidentiality
- Recordkeeping and data input
- Application assessment
- Interviewing techniques
- Document processing
- Data acquisition and evaluation
- Authorizations
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Multitasking Abilities
- Reliability
- Strong verbal communication
- Strategic problem resolution
- Team collaboration
- Adaptability and flexibility
- Financial product knowledge
- Task prioritization
- Self motivation
- Documentation review
- Deadline management
- Information gathering
- Document preparation
Timeline
Referral and Authorization Specialis
Providence Swedish Medical Center
11.2022 - Current
ADMINISTRATION ASSISTANT
ITS CONGLOBAL INDUSTRIES
11.2018 - 11.2022
FRONT OFFICE SUPERVISOR / PATIENT REGISTRAR
US HEALTH WORKS MEDICAL GROUP
08.2007 - 03.2018
PATIENT COORDINATOR / MEDICAL RECORD CLERK III / NUTRITION DIET CLERK
SWEDISH MEDICAL CENTER FIRST HILL CANCER INSTITUTE
09.1992 - 01.2007
Certificate - Data Processing and Data Entry
ITT Technical Institute
Certificate - Patient Billing and Coding
Renton Technical College
AA Business Administration -
Bellevue Community College