Stephanie Landers

• Review and process prior authorization requests for medical services and procedures.
• Coordinate communication between healthcare providers, insurance companies, and patients to facilitate approvals.
• Maintain accurate documentation of authorization activities in electronic health record systems.
• Ensure compliance with regulatory requirements and company policies throughout authorization processes.

Verified patient eligibility, benefits, and coverage limits with insurance carriers to ensure timely access to care.

File prior authorization requests and track them using electronic medical record (EMR) software.

Communicating with doctors, clinics, and insurance agents to gather missing medical records or test results.

Research claim denials, handle appeals, and process retro-authorizations when required.

Developed standard operating procedures to enhance efficiency in handling prior authorizations.

Assisted in training new staff on workflows and best practices for prior authorization management.

• Communicated with healthcare providers to facilitate timely patient care transitions.
• Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
• 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.
• Served as a liaison between primary care physicians, specialists, and patients to ensure timely access to needed services.

• Assisted with day-to-day operations, working efficiently and productively with all team members.
• Paid attention to detail while completing assignments.
• Ensure records meet legal, HIPAA, and state standards
• Audit electronic health records for completeness and accuracy.
• Worked effectively in fast-paced environments.

• Knowledge of ICD 9/10 and CPT coding
• Making sure correct patient chart notes and appropriate documentation was received from the office that was referring the patient to a specialist.
• Developed professional relationships with providers/specialists
• Attaching correct criteria and guidelines
• Verifying patient eligibility and benefits
• Proficient with medical terminology
• Familiar with HMOs, PPOs and IPAs.
• Navigating insurance websites in particular: Blue Cross, Blue Shield, Health Net, Aetna, and United HealthCare.
• Ability to work independently and as a team player with customer service
• Prioritize work load and maintain an organized work space.
• Deadline driven to make sure referrals were processed in a timely manner and stayed within the compliance guidelines.

• Knowledge of ICD 9/10 and CPT coding
• Making sure correct patient chart notes and appropriate documentation was received from the office that was referring the patient to a specialist.
• Developed professional relationships with providers/specialists
• Attaching correct criteria and guidelines
• Verifying patient eligibility and benefits
• Proficient with medical terminology
• Familiar with HMO’s, PPO’s and IPA’s.
• Navigating insurance websites in particular; Blue Cross, Blue Shield, Health Net, Aetna, and United HealthCare.
• Ability to work independently and a team player with customer service
• Prioritize work load and maintain an organized work space.
• Deadline driven to make sure referrals were processed in a timely manner and stayed within the compliance guidelines.

• Welcomed patients and visitors warmly while managing front desk check-ins and reducing wait times.
• Collected and entered accurate personal, demographic, and billing data into electronic health record (EHR) systems.
• Verified insurance eligibility and benefits prior to appointments to ensure clean claims and proper coverage.
• Collected co-pays, deductibles, and payments at the point of service with total financial accuracy.
• Scheduled patient appointments, managed cancellations, and coordinated patient flow with clinical staff.
• Maintained strict patient privacy and compliance with HIPAA and healthcare facility rules.

• Reviewed and processed prior authorization requests for medical services and procedures.
• Coordinated communication between healthcare providers, insurance companies, and patients to facilitate approvals.
• Maintained accurate documentation of authorization activities in electronic health record systems.
• Ensured compliance with regulatory requirements and company policies throughout authorization processes.

• Patient scheduling, checking in and out/ handling up to 4 phone lines
• Obtaining updated patient information including demographics such as; correct spelling of patients name, address, DOB verification and updated insurance information.
• Verifying patient insurance eligibility.
• Collecting copays, co-insurances, deductibles and patient balances.
• Ensuring accurate data entry of all patient information from their sign in sheet.
• Position was a “float” position which required that I work multiple satellite locations handling scheduling, checking in and out of the patients, collecting copays and insurance verification with excellent customer service.
• Scanning documents and routing to proper personnel for review.
• Eagerness to learn and expand knowledge prompted me to seek projects from fellow departments.