Stephanie Beauford
Referral Coordinator
Middleburg,FL
Summary
Objective To secure a challenging position within an organization that fosters continuous learning, leverages my skills, and offers opportunities to excel in a dynamic environment, while pursuing a rewarding and fulfilling career.
Overview
22
22
years of professional experience
Work History
Referral Coordinator
Baptist Medical Center
08.2021 - 08.2023
- Processed patient referrals to internal and external services, ensuring efficient and timely handling
- Reviewed and processed incoming referrals (electronic/fax) promptly, avoiding duplications and ensuring completion
- Training of new employees on a 90 day probation period.
- Tracked referrals meticulously to verify documentation in the Electronic Medical Record (EMR) and accuracy of diagnosis code and participating insurance plans
- Contacted patients to obtain medical history, ordered necessary testing, scheduled appointments, and facilitated the completion of new patient paperwork
- Received, distributed, and processed faxes related to patient care, maintaining a high level of organization
- Assisted with incoming calls and performed additional duties as required
- Confirmed insurance coverage through payer portals and determined the need for pre-authorization
- Obtained authorization and processed referrals for services ordered by providers, ensuring appointments were scheduled within required time frames and adhering to appropriate network and payer guidelines
- Effectively communicated with patients, healthcare providers, and third-party service providers regarding insurance coverage and any barriers to care
- Documented detailed information in patient medical records, including authorization status, coverage issues, restrictions, and appointment details
- Proactively notified patients and providers when requested services were not authorized by insurance
- Collected essential demographic, insurance, and clinical information from patients and accurately entered it into the designated database
- Proactively addressed concerns or questions regarding prescribed procedures, diligently seeking appropriate resources to resolve any issues related to specific type, date, or location of procedures
- Efficiently scheduled patient procedures, optimizing both the patient's time and clinical resources
- Coordinated and communicated schedules effectively, ensuring smooth workflow and minimizing scheduling conflicts
- Assisted in coordinating activities associated with insurance pre-certification and authorization processes
- Provided comprehensive counseling to patients, participants, or their representatives, offering guidance on pre-service requirements and instructions to ensure a seamless healthcare experience.
- Optimizing the timely transmittal of accurate and clean claims daily.
- Identified and obtained invalid/missing claims data by communicating with other departments.
- Secured and corrected the data which prevented claims transmission by protecting payer filing deadlines by utilizing all available resources to resolve held claims.
- Assures all known regulatory, contractual,compliance, and BHSF guidelines are adhered to.
- Utilizes available system issues to the Billing manager.
- Sent invoices and account updates.
- Addressed and resolved client questions and issues relating to invoices, and providing regular, accurate reports of billing data.
Centralized Scheduler/Patient Access
HCA Florida Orange Park Hospital
04.2007 - 08.2021
- Scheduled patients for a wide range of ancillary, surgical, diagnostic, and medical testing/procedures/admissions using Meditech module system
- Collaborated closely with physician's offices and staff to ensure acquisition of necessary pre-certifications/authorizations codes and relevant numbers
- Managed 50-70 calls per day.
- Assisted in identifying, documenting, and communicating scheduling best practices to enhance best qualities of facility staff schedules, serving as first mentor and coach to local scheduling and staffing offices
- Managed incoming orders received via fax from doctors' offices, promptly contacting patients and/or physicians' offices as needed
- Training of new employees.
- Selected accurate Insurance carrier plans according to patients carrier.
- Indexed incoming orders received and scheduled according to test name and type.
- Ensuring that all patients demographics are correct.
- Organized workflow and appointment by reading and routing correspondence, collecting patients information, and managing assignments.
- Communicate schedule changes to relevant parties in a timely manner.
- Ran daily reports on Medical Necessity for Medicare patients, ensuring compliance with regulatory requirements
Scheduler/Customer Service Rep/Billing Specialist
UF Health/SHANDS
02.2002 - 04.2007
- Demonstrated professionalism and promptness in answering multi-line telephone calls
- Received and efficiently distributed incoming pre-cert mail, while accurately performing data entry for all authorizations, ICD-9, and CPT codes
- Sent invoices and account updates to clients
- Keep accurate record of client accounts and outstanding balances.
- Receive, Sort, and track incoming payments
- Validate debit accounts to ensure the credibility of payments.
- Utilized online database systems and Order Facilitator to retrieve and manage reservations
- Ensured clinical reservations were organized and readily accessible for incoming patients
- Collected co-pays from patients, ensuring accurate recording and handling of payments
- Skillfully managed front desk check-in/out processes, providing excellent customer service
- Conducted callbacks to members and providers to communicate authorization decisions promptly
- Documented outbound calls, clarifying, following up, and resolving customer inquiries with attention to detail
- Created cases in the authorization system as necessary, ensuring comprehensive documentation
- Maintained strict adherence to HIPAA regulations, safeguarding patient privacy and confidentiality
- Stayed updated on department policies, procedures, plan benefit designs, and modifications
- Provided assistance to other departments during periods of backlog, fostering teamwork and collaboration
- Completed initial reviews of all faxed material, ensuring accuracy and timely processing
- Managed and triaged calls and electronic cases, identifying those requiring clinical intervention and prioritizing accordingly
- Maintained utmost confidentiality in handling medical records and sensitive patient information
- Assisted in scheduling members' medical appointments, ensuring timely and appropriate care for Health Plan customers
- Processed referrals for patients' outpatient appointments, directing them to the appropriate facilities
- Effectively communicated with patients, healthcare providers, and third-party service providers, addressing insurance coverage and any obstacles to care
- Conducted insurance verifications, confirming coverage details and limitations
- Documented comprehensive information in patient medical records, including authorization status, coverage issues, restrictions, and appointment details
- Notified patients and providers promptly about services that were requested but not authorized by insurance
- Gathered essential demographic, insurance, and clinical information from patients and accurately recorded it in the designated database.
Education
MA - Medical Assistance
North Florida Institute
Orange Park, FL10.2003
High School Diploma -
Palatka High School
Palatka, FL06.1993
Skills
- Coding, Icd, Cpt coding, Icd-9 (10 years), Cpt, ICD-10
- Training, Onboarding, Time Management, Organizational Skills
- Customer service (10 years), Front Desk
- Service department, Phone Etiquette
- Clerical (10 years), Reception, Medical Scheduling (10 years)
- Microsoft Excel (10 years), Excel, Word, Publisher, Outlook
- Isolated Billing System
- Open Billing System
- Medical Office Experience, Medical Terminology
- Medical Billing, Medical Records, Data Entry
- Hospital Experience
- Insurance Verification
- EPIC, EMR Systems, HIPAA, Triage, Patient Care, Anatomy Knowledge, Vital Signs
Timeline
Referral Coordinator
Baptist Medical Center
08.2021 - 08.2023
Centralized Scheduler/Patient Access
HCA Florida Orange Park Hospital
04.2007 - 08.2021
Scheduler/Customer Service Rep/Billing Specialist
UF Health/SHANDS
02.2002 - 04.2007
MA - Medical Assistance
North Florida Institute
High School Diploma -
Palatka High School
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