Stephanie Lewis-Sapp
VALDOSTA,GA
Summary
Results-driven Insurance Authorization Specialist recognized for professionalism and commitment to patient care. Skilled in managing high-volume caseloads and reducing turnaround times, ensuring seamless transitions and adherence to regulatory requirements.
Overview
32
32
years of professional experience
Work History
Insurance Authorization Specialist
SGMC Health
Valdosta, Georgia
08.1994 - Current
- Implemented best practices that reduced authorization turnaround times, enhancing patient care delivery.
- Collaborated with healthcare providers to obtain necessary documentation for timely insurance approvals.
- Processed insurance authorizations for diverse medical services, ensuring compliance with regulatory requirements.
- Utilized electronic health record systems to track authorization statuses and streamline communication.
- Collaborated with healthcare providers to ensure proper documentation for successful authorizations.
- Achieved higher accuracy rates in authorizations, utilizing attention to detail and organizational skills.
- Developed strong working relationships with physicians' offices resulting in a smoother flow of required documents when submitting requests.
- Ensured continuity of care for patients by tracking expiring authorizations and initiating renewals as needed.
- Coordinated pre-authorization requirements for medical treatments or services, enhancing overall patient experience before appointments.
- Managed high-volume caseloads to meet strict submission deadlines, prioritizing tasks accordingly.
- Enhanced patient satisfaction rates through timely and accurate insurance verifications.
- Maintained comprehensive knowledge of various insurance plans, ensuring accurate information was provided during the authorization process.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained confidentiality of patient finances, records, and health statuses.
Placement Specialist
SGMC HEALTH
Valdosta, GA
08.1994 - Current
- Coordinated patient admissions and discharges, facilitating seamless transitions and adherence to facility protocols.
- Monitored bed availability using electronic health record systems to optimize patient placement efficiency.
- Collaborated with multidisciplinary teams to assess patient needs and recommend appropriate care settings.
- Trained new staff on hospital policies related to patient placement and utilization of management systems.
- Led initiatives to enhance communication channels between departments, resulting in timely patient placements.
- Served as a liaison between medical teams and insurance companies, facilitating smooth transitions of care while minimizing financial burdens on patients and their families.
- Continuously monitored bed availability across multiple units, effectively allocating resources to optimize usage and minimize delays in care delivery.
- Collaborated with interdisciplinary teams during daily huddles, sharing insights on current bed status and potential challenges affecting patient placements.
- Enhanced patient satisfaction by promptly addressing concerns and providing appropriate solutions in a timely manner.
- Worked closely with nursing managers to address staffing issues affecting overall efficiency in bed management processes within the facility.
- Maintained strict adherence to HIPAA regulations when handling sensitive patient information during all stages of the placement process.
- Participated in regular team meetings to discuss case updates, challenges faced, and brainstorm innovative solutions for enhanced patient care delivery.
- Served as a resource for clinical staff on matters related to bed management, providing guidance and support in their decision-making process.
- Reduced patient wait times with efficient bed management strategies and effective prioritization of patients based on urgency.
- Collaborated closely with clinical staff to ensure timely admission, transfer, and discharge of patients for smooth hospital operations.
- Proactively identified potential bottlenecks in the placement process, taking corrective actions as needed to prevent delays or disruptions in service delivery.
- Established strong relationships with external facilities for seamless patient transfers while maintaining quality care standards.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Communicated with patients, ensuring that medical information was kept private.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
ER Admissions Clerk
SGMC HEALTH
Valdosta, GA
08.1994 - Current
- Processed patient admissions efficiently, ensuring accurate data entry and compliance with hospital protocols.
- Coordinated communication between departments to facilitate seamless patient transitions into care.
- Managed electronic health records system, maintaining accuracy and confidentiality of sensitive information.
- Assisted in training new staff on admission procedures and use of hospital software systems.
- Monitored and responded to inquiries regarding admission status from patients and families effectively.
- Provided support to families during stressful situations, offering empathetic assistance when needed.
- Provided clear instruction to patients regarding required paperwork, expediting their admission process.
- Improved patient satisfaction by providing excellent customer service during the admission process.
- Enhanced efficiency in the ER through effective multitasking and management of high-pressure situations.
- Collaborated with medical staff to ensure accurate and timely communication of patient information.
- Ensured accurate data entry into electronic health record systems, reducing potential errors that could impact patient care or billing processes.
- Maintained patient confidentiality by adhering to HIPAA regulations and hospital policies.
- Reduced wait times for patients with prioritization of urgent cases upon arrival.
- Trained new Admissions Clerks on departmental procedures, improving overall productivity within the team.
- Assisted in decreasing errors on insurance forms, ensuring swift processing and payment for services rendered.
- Supported hospital initiatives aimed at enhancing overall patient experience, contributing to a patient-centered approach in the ER admissions process.
- Managed patient records accurately, ensuring thorough documentation for billing purposes and future care needs.
- Streamlined ER admissions process by implementing efficient patient intake procedures.
- Optimized workflow within the admissions area, creating an organized space conducive to efficient operations.
- Facilitated smooth transfer of patients from ambulance to ER, maintaining clear communication with paramedics and medical staff.
- Exceeded department-specific productivity standards, collection targets, quality audit scores for accuracy productivity and collection standards for registrations and insurance verifications.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Performed various administrative tasks by filing, copying and faxing documents.
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Obtained payments from patients and scanned identification and insurance cards.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Registered and verified patient records before triage with most up-to-date information.
- Greeted visitors and initiated triage processes for clients to streamline patient flow.
- Conducted patient intake interviews, recording and documenting relevant information.
Education
Associate of Science - General Studies
Georgia Military College
Valdosta, GAMedical Office Assistant - Medical Office Assistant
Valtosta Technical College
Valdosta, GASkills
- Insurance verification expertise
- Prior authorizations
- HIPAA compliance
- Medical terminology proficiency
- Data entry
- Insurance verification
- Effective communication
- Active listening
Timeline
Insurance Authorization Specialist
SGMC Health
08.1994 - Current
Placement Specialist
SGMC HEALTH
08.1994 - Current
ER Admissions Clerk
SGMC HEALTH
08.1994 - Current
Associate of Science - General Studies
Georgia Military College
Medical Office Assistant - Medical Office Assistant
Valtosta Technical College