Stacy Raymond
Arroyo Grande,CA
Summary
Dynamic Authorization Coordinator at Alta Orthopaedics with expertise in prior authorization and strong communication skills. Proven track record of enhancing patient care through efficient coordination and proactive management of insurance approvals. Recognized for reducing documentation errors and improving organizational growth while maintaining professionalism and adherence to healthcare regulations.
Overview
15
15
years of professional experience
Work History
Authorization Coordinator
Alta Orthopaedics
08.2022 - Current
- Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
- Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
- Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
- Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
- Reviewed authorizations from payer to determine approved or denied items.
- Submitted for prior authorization with required documentation to appropriate funding source.
- Maintained consistent follow-up on status of prior authorization requests.
- Reviewed documentation for accuracy and assessment of necessity.
- Provided exceptional customer service to patients, addressing their concerns related to insurance coverage and authorizations promptly and empathetically.
- Conducted thorough reviews of medical records to identify and address potential issues affecting authorization approvals.
- Acted as a resource for clinical staff, providing guidance on insurance requirements and authorization protocols.
- Reduced errors in documentation submissions by performing meticulous quality checks before forwarding them to insurance companies.
DMEPOS Coordinator
JDX Pharmacy
12.2021 - 08.2022
- Spearheaded efforts aimed at updating existing protocols as per evolving industry trends; ensured ongoing alignment organizational objectives and federal guidelines.
- Reduced clerical errors by conducting regular audits and providing staff with comprehensive training on documentation procedures.
- Assisted in the preparation and submission of accreditation applications for various DMEPOS programs, ensuring compliance with all relevant standards.
- Worked closely with billing specialists to resolve discrepancies between invoicing records and payments received from insurance providers or patients themselves.
- Implemented quality control measures, ensuring compliance with regulatory standards and reducing instances of nonconformance.
Admissions Coordinator
Valley Oaks Post Acute / Santa Maria Post Acute
03.2020 - 12.2021
- Confirmed all insurance benefits met standards of admissions as dictated by policy.
- Assisted in patient admission process based on federal and state laws.
- Collaborated with admissions team to develop and implement strategies to improve admissions process.
- Maintained accurate records of applicant data, ensuring timely decision-making and reporting.
- Managed a high volume of applications, resulting in a smooth enrollment process for all parties involved.
- Streamlined patient admissions process by implementing effective communication strategies and efficient data entry techniques.
- Enhanced patient experience by providing compassionate assistance throughout the admissions process.
- Maintained a high level of customer service with patients, families, and visitors by consistently displaying empathy, professionalism, and excellence in communication skills.
- Maintained accurate records in electronic health system while safeguarding confidential patient information at all times.
- Assisted case managers in coordinating post-discharge services such as home health care or rehabilitation facilities arrangements when needed.
Medical Assistant Team Leader
Ventana Health Systems
08.2010 - 02.2012
- Increased patient satisfaction rates through proactive follow-ups on lab results and timely communication of pertinent information.
- Created an organized workspace by implementing efficient documentation practices and streamlining recordkeeping systems.
- Supported healthcare providers by preparing examination rooms promptly before each appointment.
- Established positive rapport with patients through empathetic communication and attentive service.
- Maintained strict adherence to HIPAA regulations, protecting patient confidentiality and safeguarding sensitive information.
- Assisted with clinical procedures, ensuring physician''s instructions were followed accurately for optimal patient outcomes.
- Promoted a safe working environment by adhering to infection control protocols in accordance with OSHA guidelines.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
Education
High School Diploma -
Arroyo Grande High School
Arroyo Grande, CA06-1993
Associate of Applied Science - Medical Assisting
Santa Barbara Business College
Santa Maria, CA06-2010
Associate of Applied Science - Vocational Nursing
Santa Barbara Business College
Santa Maria, CA06-2015
Associate of Arts - Early Childhood Studies
Allan Hancock College
Santa Maria, CA05-1997
Skills
- Prior authorization
- Strong communication skills
- Organizational growth
- Critical thinking
- Insurance verification expertise
- Effective time management
- Professionalism and ethics
- Healthcare regulations
Timeline
Authorization Coordinator
Alta Orthopaedics
08.2022 - Current
DMEPOS Coordinator
JDX Pharmacy
12.2021 - 08.2022
Admissions Coordinator
Valley Oaks Post Acute / Santa Maria Post Acute
03.2020 - 12.2021
Medical Assistant Team Leader
Ventana Health Systems
08.2010 - 02.2012
High School Diploma -
Arroyo Grande High School
Associate of Applied Science - Medical Assisting
Santa Barbara Business College
Associate of Applied Science - Vocational Nursing
Santa Barbara Business College
Associate of Arts - Early Childhood Studies
Allan Hancock College
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