Tonia Morgan
Las Vegas,NV
Summary
Skilled Referral Coordinator with 15 years of experience managing referrals for 16 providers. Reputation for skillfully communicating with stressed patients and ensuring full satisfaction. Thrive in a high-volume call center environment.
Overview
10
10
years of professional experience
Work History
Um Administrator Cooordinator 2
Humana
Las Vegas, NV
03.2023 - Current
- Schedule peer to peer appointments for providers.
- Make sure the authorization is correct in the system and forward to the appropriate department.
- Send offers letters to facilities once denied so they can schedule a peer to peer.
- Fax overturned letters, approvals and denials to facilities
Referral Coordinator
Centerwell Senior Primary Care
Henderson, NV
02.2021 - 03.2023
- Scheduled patients according to availability, urgency and insurance authorization guidelines.
- Managed up to 50 patient referrals daily through multi-line telephone system.
- Developed productive working relationships with numerous insurance company representatives.
- Reviewed demographic, clinical and insurance information before sending to referred specialists.
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
- Reviewed referral details and expectations with providers and patients and requested new referrals when necessary.
- Answered questions and resolved concerns raised by both patients and specialists.
- Verified documents and associated records to catch and resolve discrepancies.
Surgery Scheduler/Admissions Representative
Orthopedic Specialty Hospital of nevada
Las Vegas, Nevada
04.2019 - 09.2020
- Created and maintained accurate and confidential patient files according to regulatory mandates.
- Checked patient insurance and collected pre-authorizations from providers.
- Gathered current medical information and reviewed histories to gather details for surgeons.
- Distributed treatment and procedural information to patients.
- Managed patient check-in and check-out procedures and processed payments.
- Coordinated work processes and routed paperwork to appropriate physicians and staff members.
- Booked surgeries according to physician volume and maintained prompt turnaround times.
- Conveyed information to patients about arrival times and preoperative procedures.
- Checked physician orders and schedule availability to make accurate appointments for tests and surgical procedures.
- Used accurate procedure codes for billing purposes and to help operating teams be correctly prepared for each operation.
- Organized patient medical records and worked with insurance company representatives to obtain authorization.
Diagnostic Scheduler
nevada orthopedic and spine center
Las Vegas, NV
01.2015 - 04.2019
- Scheduled and confirmed appointments.
- Entered information into system to update status reports.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Notified ordering providers of denied authorizations.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Maintained files for referral and insurance information, entering referrals into system.
- Scheduled patient appointments, diagnostic specialty appointments, tests and procedures.
Education
Medical Assistant -
Academy of Medical And Business Careers
Las Vegas, NV06.2000
High School Diploma -
West Anchorage High School
Anchorage, AK05.1998
Skills
- Insurance precertification processes
- Multi-line phone proficiency
- Patient scheduling
- MS Office expertise
- Check authorization
- Schedule peer to peer appointments
Timeline
Um Administrator Cooordinator 2
Humana
03.2023 - Current
Referral Coordinator
Centerwell Senior Primary Care
02.2021 - 03.2023
Surgery Scheduler/Admissions Representative
Orthopedic Specialty Hospital of nevada
04.2019 - 09.2020
Diagnostic Scheduler
nevada orthopedic and spine center
01.2015 - 04.2019
Medical Assistant -
Academy of Medical And Business Careers
High School Diploma -
West Anchorage High School