SUSANA CORLETTO

• Performs pre-registration, insurance verification and financial clearance activities in a variety of settings and for multiple patient types
• Communicates frequently with patients/family members/guarantors, and physicians or their office staff in the deployment of key activities
• Interviews patients to collect data, initiates electronic medical records, validates and enters data related to procedures, tests and diagnoses
• Determines need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and contacts physicians and Case
• Management/Utilization Review personnel, as needed
• Obtains and verifies accuracy and completeness of physician orders for tests and procedures, which includes name, date of birth, diagnosis, procedure, date, and physician signature to minimize risk to hospital reimbursement
• Accurately uses patient search feature to find correct patient information and disseminates data to clinical systems for patient care
• Identifies required forms or templates based on types of services patients will receive.

-Filed claims using all appropriate forms and attachments.

-Researched account denials and file written appeals, when necessary

-Evaluate the information received from the client to determine which insurance to bill and attain necessary attachments or supporting documentation to send with each claim.

-Ensure the integrity of each claim that is billed.

-Document in detail all efforts in CUBS system and any other computer system necessary.

-Verify Patient information and benefits.

-Appeal accounts in writing.

-Draft letters to client.

Maintain confidentiality of account information at all times.

-Maintain awareness of and actively participate in the Corporate Compliance Program.

-Assist with other projects as assigned by management.

-Maintain good working relationships with State and Federal agencies.

-Resolve accounts in a timely manner.

-Meet specified goals and objectives as assigned by management on a regular basis.

• Screen patients on-site at hospitals for eligibility assistance programs either bedside or in the ER
• This includes providing information and reports to client contact(s), keeping them current on our progress
• Review hospital census or utilize established referral method to identify self-pay patients on a daily basis
• Screen those patients who are in-house and are designated self-pay for state, county and/or
• Federal eligibility assistance programs
• Initiate application process when possible
• Identifies specific patient needs and direct them to the appropriate agency for assistance
• Introduces patients to Med Assist services and informs them that we will be contacting them on a regular basis about their progress
• Provides transition, as applicable, for the backend Patient Account Representatives to develop a positive relationship with the patient
• Records all patient information on the designated in house screening sheet
• Document the results of the screening in the onsite tracking tool and hospital computer system
• Identifies out-patient accounts from the census or applicable referral method that are designated as self-pay
• Reviews system for available information for each outpatient account identified as self-pay
• Screen patients in ER as able
• Attempts to reach patient by telephone if unable to screen on site
• Document out-patient accounts when accepted in the hospital system and on site tracking tool.