Summary
Overview
Work History
Education
Skills
Timeline
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Serena Meadows

Fortuna

Summary

Adept at streamlining processes, I significantly contributed to St Joseph Health by enhancing workflow efficiency and patient care through expert prior authorization processing and exceptional communication skills. My proactive approach and dedication to confidentiality led to consistently surpassing productivity targets, demonstrating a blend of hard and soft skills vital for healthcare administration.

Overview

27
27
years of professional experience

Work History

Referral Coordinator

SoHum Health Clinic
06.2014 - Current
  • Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
  • Scheduled appointments with specialists on behalf of clients.
  • Maintained a high level of accuracy in referral documentation, ensuring smooth transitions between healthcare providers.
  • Processed referral requests from patients, doctors and other health care professionals.
  • Responded to patient inquiries to offer timely updates regarding referral status.
  • Called insurance companies to get precertification and other benefits information on behalf of patients.
  • Served as a liaison between primary care physicians, specialists, and patients to ensure timely access to needed services.
  • Managed electronic health records efficiently, safeguarding sensitive patient information while expediting the referral process.
  • Provided exceptional customer service, addressing patient concerns and inquiries regarding the referral process.
  • Developed and maintained strong working relationship with referral sources to streamline processing.
  • Developed comprehensive knowledge of insurance requirements, advocating for patients when necessary to secure approval for needed services.
  • Assisted with completion of referral forms and verified data accuracy and completion
  • Supported clinical team in managing complex cases through effective coordination of multiple referrals and appointments.
  • Assisted with staff training initiatives related to the referral process, sharing expertise gained from professional experience.
  • Contributed to patient education by providing relevant information about their referral process and expectations.
  • Fostered positive relationships with external healthcare facilities and specialists to expand referral options for patients.
  • Supported healthcare providers with timely access to patient referral information, aiding in better clinical decision-making.

Authorization Specialist

St Joseph Health
12.2008 - 06.2014
  • 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.
  • Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
  • 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.
  • Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
  • Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.

Commercial Insurance Biller

St Joseph Health
02.1998 - 06.2014
  • Expedited claim processing times by efficiently submitting claims to insurance carriers on behalf of clients.
  • Responded to customer concerns and questions on daily basis.
  • Audited and corrected billing and posting documents for accuracy.

Education

Sociology

Calpoly Humbomdt State
Arcata, CA
1997

Associate Of Arts - Liberal Arts

College of The Redwoods
Eureka, CA
1994

Skills

  • Prior authorization processing
  • Effective communication skills
  • Telephone etiquette
  • Confidentiality

Timeline

Referral Coordinator

SoHum Health Clinic
06.2014 - Current

Authorization Specialist

St Joseph Health
12.2008 - 06.2014

Commercial Insurance Biller

St Joseph Health
02.1998 - 06.2014

Sociology

Calpoly Humbomdt State

Associate Of Arts - Liberal Arts

College of The Redwoods

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Serena Meadows