Tricia Talavera

• Checked in the walk-in patients to be seen by emergency room provider.

• Provided new patient demographics.

• Applied wristbands on patients prior to be taken back for treatment/care.

• Entered demographics into database.

• Ran insurance for deductibles, out-of-pocket and copayments.

• Discharged patients, obtaining signatures prior to departure.

• Collected payments, if applicable.

• Faxed facesheets to bigger hospitals for admissions.

• Obtained AHCCCS applications for patients that applied and sent them to AHCCCS for approval.

• Sorted incoming faxes, labelled them and placed them in a folder for nurses to review.

• Sorted incoming mail, distributed it and sent it to medical records to fulfill request.

• Roomed patients with the charge nurse’s approval.

• Scheduled office and hospital based medical procedures, for patients with appropriate provider and time/location slot, utilizing appropriate scheduling codes.

• Scheduled diagnostic and imaging test to be completed. Schedule office in hospital based medical procedures, test and imaging ensuring available time is utilized to maximum efficiency.

• Interfaces with appropriate vendor staff to ensure all necessary equipment will be used on site for office and hospital based procedures, including scheduling with contracted anesthesia groups.

• Interfaces with appropriate hospital staff to ensure a cohesive working relationship and providing patient care services.

• Entered in all notes and special instructions needed for scheduling in the electronic medical record.

• Effectively utilized clinical knowledge when determining if an appointment is consistent with the diagnosis/indications indicated by the provider.

• Completed accurate documentation of informed consent with patients for procedures and surgeries as needed.

• Provided accurate and detailed information to patients regarding test preparations, time of patient’s scheduled arrival and any other directional information needed, take appropriate action in responding to questions from patients.

• Confirmed patients insurance, provider and obtained prior authorization or communication needed for prior authorization to appropriate party that needed.

• Ensured patients have proper medical clearance and pre-surgical testing as needed.

• Completed pre-procedure phone calls and confirm appointment times with patients via telephone.

• Ensured proper follow up appointments are scheduled at the time of the procedure is scheduled.

• Other duties assigned.

• Entered and process specialty referrals for primary care practice.

• Obtained authorizations and eligibility verifications.

• Transmitted medical records via HIPAA /compliant process.

• Communicated with all patient’s telephonically and via secure patient portal.

• Sorted and distribute incoming documentation.

• Participated in community outreach events servicing the LGBTQ community.

• Entered and processed specialty referrals for women’s health clinic.

• Obtained daily newborn logs from physicians and midwife at the hospital.

• Obtained authorization for McKena and Lupron Injections.

• Handled daily incoming calls and task request from patients and providers. – Eligibility verification for impatient, vaginal and C-section births.

• Transmitted medical records via HIPAA/compliant process/communicate with patient’s telephonically and face-to-face.

• Served at the back up for front desk and follow up appointment.

• Scheduled follow up and new patient appointments.

• Prepared charts and daily schedules for therapist.

• Obtained authorizations and/or referrals. –

• Handled incoming calls and messages.

• Managed cash and credit transactions.

• Managed front desk check-in’s.

• Process impatient admission reports. –

• Process impatient and outpatient charge entry tickets. (Avg. 600/daily)

• Managed daily task (such as billing errors and patient demographic updates)

• Sorted and distributed in our office mail.

• Entered and processed internal referrals for 12 physicians.

• Obtained authorizations and eligibility verifications.

• Answered calls from providers and patient regarding referrals and authorizations.

• Acted as backup for other specialties during absences.

• Sorted and distributed incoming documentation.

• Processed and scrubbed new member enrollment applications
• Coordinated the daily flow of applications
• Monitored the CMS website, team mail/fax boxes, for new enrollment.
• Performed telephonic enrollments
• Trained and coach coworkers on the member enrollment application process
• Prepared prepared packets for prospective members as requested by sales reps.
• Maintained daily inventory of supplies and packets.
• Participated in new member, orientation, meetings, and member education events
• Made outbound transition of care calls to members.

• Handled them coming phone calls for members and healthcare providers
• Facilitated pre-certifications and prior authorizations for members and providers.
• Coordinated pier to pier, phone calls between medical directors and referring physicians
• Sorted and distributed, incoming faxes, face sheets, and mail for nurses to review
• Verified benefit and insurance coverage.
• Trained and coached new employees.