TRACEY HELGESON

Gundersen Health System

La Crosse, Wisconsin

03.2008 - Current

Ensure patient satisfaction by using effective communication to collaborate with providers, staff, and third-party payers for best practices and best outcomes.
Facilitate the timely submission of Prior Authorization requests through electronic systems, insurance portals, fax, and phone.
Proactively monitor and follow up on the status of requests to ensure prompt processing, utilizing precision and attention to detail to alleviate denials and appeals.
Work as a team with other Revenue Cycle departments and Revenue Cycle Management, ensuring the appeals process is done accurately and in a timely manner.
Proficient in EMR and EPIC systems.
Conducted collection calls after investigating all outcomes, utilizing courtesy and professional skills.
Resolved discrepancies in authorization submissions through effective problem-solving.
Maintained accurate documentation of interactions and decisions related to authorizations.
Ensure compliance with guidelines.
Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
Supervise, evaluate, and train staff on the prior authorization process and systems from start to finish.
Collaborated with Revenue Cycle Management to streamline processes and build/facilitate new processes/efficiencies with the rest of the team.