Tammy Groom
Hopkinsville,KY
Summary
Results-driven, motivated Referral Specialist with extensive experience in coordinating patient referrals and managing high-volume call center requests. Skilled in maintaining accurate records and enhancing operational efficiency to ensure timely access to specialty care. Proficient in the use of Epic, Athena, and ECW EMR systems. Excelling in communication, problem solving, and multi-tasking.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Referral Specialist
Pennyroyal Healthcare Associates
Hopkinsville, KY
08.2023 - Current
- Manage 40 - 50 calls per day with patients, providers, and insurance companies
- Coordinate patient referrals to ensure timely access to specialty care.
- Utilize electronic health record systems to track referral statuses and follow-ups.
- Communicate effectively with healthcare providers to streamline referral processes.
- Monitor referral trends, identifying areas for process improvement and operational efficiency.
- Educate patients on referral procedures, enhancing understanding and satisfaction levels.
- Collaborate with interdisciplinary teams to resolve issues related to patient referrals.
- Develope training materials for new staff on referral protocols and system usage.
- Call insurance companies to get precertification and other benefits information on behalf of patients.
- Collaborate with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Streamline referral processes for increased efficiency, resulting in timely appointments for patients.
- Verify insurance benefits and eligibility for physical therapy, home health, cardiology, and imaging procedures before referring clients.
- Promote clear communication between primary care providers and specialists through detailed documentation and follow-up calls.
- Develop strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.
- Build professional relationships with service providers.
- Maintain accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Schedule appointments with specialists on behalf of clients.
- Manage high-volume referral requests by prioritizing tasks and maintaining organized records.
- Obtain prior authorization for physical therapy, imaging, cardiology, and other specialty procedures.
- Enhance patient satisfaction by promptly addressing inquiries and resolving issues related to referrals.
- Ensure continuity of care by regularly updating patient records with recent test results or changes in medical history.
- Act as a liaison between referring physicians and specialists, establishing trust and rapport through professionalism.
- Provide ongoing training for new Referral Specialist staff members, ensuring consistent quality service delivery across the team.
- Support healthcare team members by providing detailed patient information for seamless transitions between providers.
- Answer telephone calls to offer office information, answer questions, and direct calls to st
- Assist patients in navigating insurance requirements, facilitating approval of necessary treatments.
- Maintain comprehensive knowledge of provider networks, ensuring appropriate specialist recommendations for patients.
- Link families to relevant community support to meet non-medical needs.
- Conducted regular audits of referral records to maintain compliance with industry regulations and company standards.
Patient Coordinator /Front Desk Office Manager
Dr. Rao Velaga Cardiologist
Hopkinsville, KY
01.2020 - 08.2023
- Coordinated patient appointments and follow-ups to enhance scheduling efficiency.
- Managed medical records and ensured compliance with HIPAA regulations.
- Streamlined communication between patients and medical staff to improve service delivery.
- Assisted in developing patient education materials on cardiovascular health management.
- Implemented electronic health record (EHR) systems for accurate patient data tracking.
- Increased efficiency of the front office operations through effective multitasking, attention to detail, and organization skills.
- Provided excellent customer service to all patients, addressing concerns and answering questions promptly and professionally.
- Handled sensitive situations with empathy when dealing with distressed patients or those facing serious health challenges.
- Maintained up-to-date knowledge on insurance policies, medical terminology, and clinic protocols in order to provide accurate information and assistance to patients.
- Managed incoming calls from patients, directing them appropriately while maintaining confidentiality at all times.
- Reduced wait times by effectively coordinating with medical staff on patient schedules and room availability.
- Explained upcoming treatment preparation, instructions, and other facts to patients.
- Worked with patients to schedule tests and procedures.
- Ensured accuracy of insurance information for each patient visit, verifying coverage details ahead of time for smooth processing at appointment time.
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
- Maintained confidentiality of patient data and condition to safeguard health information.
- Maintained accurate electronic health records for improved patient care and compliance with privacy regulations.
- Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
- Promoted a culture of teamwork among clinic staff by offering assistance whenever needed and fostering open communication channels.
Education
Education
Murray State University
Murray, KY12-2005
Bachelor of Science - Education
Austin Peay State University
Clarksville, TN12-1993
Skills
- Insurance verification
- Data entry proficiency
- Pre-authorizations
- Medical terminology
- Database management
- Patient confidentiality
- Appointment scheduling
- Healthcare industry
- Appointment reminders
- Scheduling software
- Medical terminology knowledge
- Notetaking and documentation
- HIPAA regulations
- MS office expertise
- Medical scheduling
- Customer service
- Insurance authorizations
Certification
Certified Medical Assistant, National Healthcareer Association 07/2023
Timeline
Referral Specialist
Pennyroyal Healthcare Associates
08.2023 - Current
Patient Coordinator /Front Desk Office Manager
Dr. Rao Velaga Cardiologist
01.2020 - 08.2023
Education
Murray State University
Bachelor of Science - Education
Austin Peay State University