Wendy Darrow
Mansfield,PA
Summary
Demonstrated knowledge of admissions, insurance verification and authorization processes in hospital and medical office settings. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
7
7
years of professional experience
1
1
Certification
Work History
OA II
UPMC Wellsboro
Wellsboro, PA
05.2023 - Current
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Recognized by management for providing exceptional customer service.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Maintained updated knowledge through continuing education and advanced training.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Assisted with customer requests and answered questions to improve satisfaction.
- Completed day-to-day duties accurately and efficiently.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Updated patient and insurance data and input changes into company computer system.
- Researched third party payer guidelines related to prior authorizations, coding and billing processes.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
- Examined claims, records and procedures to grant approval of coverage.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Navigated through multiple online systems to obtain documentation.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Participated in training sessions on new software programs used for verification purposes.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Compiled and coded patient information or data in appropriate computer system.
- Entered data in EMR database to record payer, authorization requirements and coverage limitations.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
OA II
Mansfield Laurel Health Center
Mansfield, PA
05.2019 - 05.2023
- Collected and entered payment data into system, maintaining complete confidentiality and accuracy.
- Provided administrative support to staff members, including copying and scanning documents, filing paperwork, and ordering supplies.
- Oversaw patient registration, insurance verification, form completion and appointment scheduling to maintain operational efficiency.
- Answered phones promptly and responded to inquiries from patients or providers in a professional manner.
- Conducted insurance verification and pre-certification and pre-authorization functions.
- Verified appointment times with patients, preparing charts, pre-admission and consent forms.
- Ordered clinical supplies for the office on a weekly basis ensuring all items were within budget guidelines.
- Responded to requests for medical records from other healthcare facilities or attorneys in accordance with HIPAA regulations.
- Participated in team meetings to improve workflows and contribute to improving patient population outcomes.
- Performed various clerical duties such as filing paperwork, faxing documents, photocopying records.
- Answered phones, scheduled appointments, greeted patients and ordered supplies.
- Incorporated outside records into charts and EHR.
- Entered data into computer systems accurately utilizing ICD-10 codes when applicable.
- Scheduled appointments for patients via phone and in person.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Explained reasons behind application denials and recommended further action.
- Provided customer service to internal and external customers related to authorization requests.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Reviewed authorization requests for accuracy and completeness.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Performed data entry into various computer systems including but not limited to EMRs and CRMs.
Customer Service Representative
Wayfair
Big Flats, NY
09.2018 - 05.2019
- Answered constant flow of customer calls with minimal wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Responded to customer requests for products, services, and company information.
- Handled customer inquiries and suggestions courteously and professionally.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Processed customer service orders promptly to increase customer satisfaction.
- Tracked customer service cases and updated service software with customer information.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Collected and returned unpurchased or returned items to correct shelf locations and arranged displays to promote sales.
- Recommended, selected and helped locate and obtain out-of-stock product based on customer requests.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Patient Service Representative
Troy Guthrie Medical Group
Troy, PA
04.2017 - 08.2018
- Used EPIC to schedule appointments.
- Balanced deposits and credit card payments each day.
- Managed patient registration process, confirming data accuracy and completeness.
- Verified insurance eligibility and coverage for patients.
- Resolved billing inquiries and disputes in timely fashion.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Entered patient demographic and insurance data into electronic medical record system.
- Investigated insurance claims denials and appeals.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Greeted and assisted patients with check-in procedures.
- Answered incoming calls, scheduled appointments and filed medical records.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Trained new staff on filing, phone etiquette and other office duties.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Tracked referral submission during facilitation of prior authorization issuance.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Verified eligibility and compliance with authorization requirements for service providers.
Education
High School Diploma -
Mansfield Jr. Sr. High School
Mansafield, PA06-1989
Skills
- Secure Data Practices
- Attention to Detail
- Customer Service
- Documentation and Correspondence
Certification
- CPR Certification May 2023
- CPR Certification June 2022
- CPR Certification May 2021
- CPR Certification May 2020
- CPR Certification May 2019
References
References available upon request.
Timeline
OA II
UPMC Wellsboro
05.2023 - Current
OA II
Mansfield Laurel Health Center
05.2019 - 05.2023
Customer Service Representative
Wayfair
09.2018 - 05.2019
Patient Service Representative
Troy Guthrie Medical Group
04.2017 - 08.2018
High School Diploma -
Mansfield Jr. Sr. High School
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