Summary
Overview
Work History
Education
Skills
Timeline
Generic

Trisha Daberkow

Phoenix,AZ

Summary

Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

4
4
years of professional experience

Work History

Prior Authorization Representative

Banner Healthcare
TUCSON, AZ
09.2022 - Current
  • Communicates authorization decisions, including approvals and denials, to healthcare providers and patients.
  • Educates customers about the prior authorization process, including applicable deadlines.
  • Follows all Medicare, Medicaid, HIPAA, and private insurance regulations and requirements.
  • Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
  • Helps to train new staff on prior authorization procedures when asked to do so.
  • Provides customer service to patients and healthcare providers, answering questions related to prior authorization status.
  • Coordinated with healthcare providers to gather necessary patient information for prior authorization requests when needed.
  • Reviews and processes prior authorization requests for medical procedures and medications according to established guidelines.
  • Applies knowledge of Medicare, Medicaid, and third-party payer requirements, utilizing online eligibility systems to verify patient coverage.
  • Works effectively in team environments to make the workplace more productive.
  • Assists with member requests and answered questions via the telephone to improve member satisfaction.

Medical Billing Specialist

Sierra Vista Medical Group
Sierra Vista, AZ
09.2021 - 09.2022
  • Processed credit card payments from patients in accordance with office policy.
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Reconciled codes against services rendered.
  • Assessed billing statements for correct diagnostic codes and identified problems with coding.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Reviewed claims for coding accuracy.
  • Ensured HIPAA compliance by maintaining confidentiality of all patient information.
  • Submitted claims to insurance companies.
  • Answered customer questions to maintain high satisfaction levels.
  • Performed insurance verification.
  • Verified the accuracy of claim data prior to submission to insurance carriers.

Referrals Specialist

Sierra Vista Medical Group
Sierra Vista, AZ
09.2020 - 09.2021
  • Scheduled and confirmed patient appointments and consultations.
  • Verified insurance eligibility for referred services using online databases and contacted insurers directly when needed.
  • Educated patients on the referral process, including expected timelines and preparation for specialist visits.
  • Answered telephones and directed calls to appropriate medical or administrative staff.
  • Facilitated communication between primary care physicians, specialists, and patients to ensure a smooth referral process.
  • Reviewed all documentation associated with each referral request to ensure compliance with relevant regulations when needing to do so.
  • Managed front office customer service and appointment management to help streamline workflow.
  • Performed additional office duties, handling patient service inquiries and receiving payments.
  • Answered questions and resolved concerns raised by both patients and specialists.

Education

Some College (No Degree) - Medical Secretary

Linn-Benton Community College
Albany, OR

Skills

  • Authorizations
  • Medical terminology
  • Patient scheduling
  • Data entry proficiency
  • Co-payment collection
  • Insurance verification

Timeline

Prior Authorization Representative

Banner Healthcare
09.2022 - Current

Medical Billing Specialist

Sierra Vista Medical Group
09.2021 - 09.2022

Referrals Specialist

Sierra Vista Medical Group
09.2020 - 09.2021

Some College (No Degree) - Medical Secretary

Linn-Benton Community College
Trisha Daberkow