Summary
Overview
Work History
Education
Skills
Certification
Locations
Timeline
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Tricia Nilsen

Mesa,AZ

Summary

I have worked in the Medical Field since 2007 and have 12 years experience specifically with referrals, procedure authorizations, insurance eligibility and scheduling patients.. I am efficient, organized, personable, reliable, detail orientated, good at multi tasking & a Team Player. Looking for growth, a new challenge and a new opportunity.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Procedure Authorizations Specialist

CIC Vein Center Comprehensive Interventional Care
10.2022 - Current
  • Procedure Scheduling, Insurance benefits and Authorizations for Vein Procedures (venaseal, thermal ablation- RFA, laser ablation, Varithena & STS). Also verify vein procedure will meet requirements per insurance vein policy (reading the VI reports - look at measurement of vein and reflux).
  • Authorizations, insurance benefits, and patient financial for UFE and OVE procedures.
  • Procedure scheduling for Vein Procedures in ECW and SIS. As well as putting blocks in ECW for Vein procedures under each specific provider.
  • Insurance benefits for VI's and Vein procedures.
  • Patient Financials for VI’s, all Vein Procedures, UFE’s and OVE’s

Procedure Authorizations

CAI - Cardiovascular and Arrhythmia Institute
06.2021 - 10.2022
  • Knowledgeable with Centricity, AIM, Humana Health Help, UHC and Evicore.
  • Obtain Authorizations for all OP procedures. Heart Caths, Ablations, ICD, Pacemakers and TEE/Cardioversions.

Referral Coordinator/Specialist

Banner Medical Group Neurology
04.2020 - 04.2021
  • Knowledgeable with Cerner Healthcare software.
  • Monitors all Internal referrals - General Neurology, Neuropsychology, Neurosurgery and Neuroendovascular - obtain MRI or CT if needed. Scheduling appts.
  • Process External referrals from right fax and input in Cerner. Scheduling appts.
  • Obtain authorization for NCV/EMG and EEG.
  • Contact PCP if referral is needed / Monitoring patient insurance plans - obtain referral if needed.
  • Attach Transfer of Care in Powerchart.
  • Answer incoming calls - Genesys phone software.
  • Confirmation calls as needed.
  • Knowledgeable with CPT and ICD-9.
  • Train MA's and new hires on referral workflow and processing.

Patient Care Coordinator

Swedish Neuroscience Specialists - Swedish Edmonds Neurology
11.2018 - 04.2020
  • Knowledgeable with Epic HealthCare software.
  • Liaison between the patient and various clinics and scheduling that is needed.
  • Obtaining authorizations for MRI, CT, MRA, Botox, referrals to other specialties, etc….
  • Schedule appts, verify patients insurance & Advise patient of MD instructions for follow up care -AVS.
  • Answer incoming calls.
  • EEG - Advise patient of instructions & input referral. Schedule EMG - NCV testing.
  • Monitoring referral workque, authorizing & inputting referrals in epic.

Patient Service Representative

Swedish Edmonds Heart and Vascular
07.2015 - 11.2018
  • Check in/Check out & Answering incoming calls.
  • Referrals: monitoring referral workque, inputting & obtaining referrals.
  • Verifying patients insurance. Schedule NP appts, follow ups, protime, pacemaker appts & EKG / Ziopatch.
  • Schedule for (CDIC) Diagnostic Imaging Tests - Echo, Stress Echo, Standard Treadmill & Nuclear Test.

Insurance and Authorization Specialist

Axis Physical Therapy
01.2013 - 12.2015
  • Insurance benefits (insurance benefit letters for patients) and authorizations for physical therapy appointments.

Lead Teacher Preschool Prep & Assistant Teacher Pre- K Classroom

Goddard School
01.2011 - 12.2013

Front Desk manager - Customer Service & sales

Marrott Dental
01.2007 - 12.2011
  • Answering incoming phone calls from Dentists.
  • Taking Dental supply orders via phone or fax then inputting orders into QuickBooks.
  • Outgoing phone calls to Dental Supply manufactures for order fulfillment - Purchase Orders.
  • Creating excel spreadsheet of Dental inventory in warehouse.
  • Various projects for owner of company as needed.
  • Take walk in orders as needed.

Education

Bachelor of Arts - Sociology

Whitworth College
12.1993

High School -

Bellevue High School
Bellevue, WA
12.1989

Skills

  • Customer relations
  • Expert problem solving
  • Analytical thinking
  • Documentation management

Certification

Certification in Infection Prevention & Control

Locations

  • CIC Vein Center Comprehensive Interventional Care, Tempe, AZ
  • CAI - Cardiovascular and Arrhythmia Institute
  • Banner Medical Group Neurology
  • Swedish Neuroscience Specialists - Swedish Edmonds Neurology, Edmonds, WA
  • Swedish Edmonds Heart and Vascular, Edmonds, WA
  • Axis Physical Therapy, Edmonds, WA
  • Goddard School, Buckeye, AZ
  • Marrott Dental, Mukilteo, WA
  • Whitworth College
  • Bellevue High School, Bellevue, WA

Timeline

Procedure Authorizations Specialist

CIC Vein Center Comprehensive Interventional Care
10.2022 - Current

Procedure Authorizations

CAI - Cardiovascular and Arrhythmia Institute
06.2021 - 10.2022

Referral Coordinator/Specialist

Banner Medical Group Neurology
04.2020 - 04.2021

Patient Care Coordinator

Swedish Neuroscience Specialists - Swedish Edmonds Neurology
11.2018 - 04.2020

Patient Service Representative

Swedish Edmonds Heart and Vascular
07.2015 - 11.2018

Insurance and Authorization Specialist

Axis Physical Therapy
01.2013 - 12.2015

Lead Teacher Preschool Prep & Assistant Teacher Pre- K Classroom

Goddard School
01.2011 - 12.2013

Front Desk manager - Customer Service & sales

Marrott Dental
01.2007 - 12.2011

Bachelor of Arts - Sociology

Whitworth College

High School -

Bellevue High School

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Tricia Nilsen