Victoria Prowell

Effectively handle incoming calls from patients regarding billing inquiries, processing payments, explaining HCPCS & ICD 10 Codes billed to the insurance, EOB's, Denial Reason codes, Contractual adjustments, and Deductible's/coinsurance.

Thoroughly Work closely with All Revenue Cycle Teams: Cash Posting, Revenue Integrity, Coding, and Billing to ensure proper posting of payments, Charges, and correct billing is to ensure correct invoicing to patients.

Train new Patient Financial Reps. on departmental procedures & policies affecting Patient Financial Services and operations.

Provides support to other departments staff members as needed during peak times of activity.

Research and responded to customer inquiries via phone, mychart, or mail regarding billing statements, tax letters, detailed bills, and services rendered.

Kept State of Ohio turnaround times for all prior authorization request and ensured compliance with applicable state and federal guidelines related to utilization review activities.

Collaborate with various departments such as Claims, finance, pharmacy, case management, and provider relations to ensure appropriate resource utilization across all levels of care

Participate in interdisciplinary team meetings for review, discussion of complex cases requiring coordination between multiple disciplines, departments.

Upload prior authorization request from our provider portal and rightfax regarding hospital inpatient stays, DME & diagnostic outpatient visits, Home Health, LTC,& SNF

Ensure compliance with all applicable CMS, HEDIS, NCQA, and the state of Ohio laws, rules, and regulations.