NISHELLE YOUNG
Bloomfield,CT
Summary
Responsible Medical Scheduler with solid experience in supporting patients, families and physicians. Skilled in managing patient information and coordinating and scheduling appointments. Strong organizational and multitasking skills coupled with strong work ethic. Proficient in Epic software.
Overview
10
10
years of professional experience
Work History
Procedure Scheduler
Connecticut GI
10.2023 - Current
- Managed high call volumes while maintaining exceptional customer service standards for patients and staff members.
- Assisted in improving overall patient satisfaction through timely and accurate schedule management.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy.
- Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
Prior Authorization Specialist
Hartford Hospital Radiology
04.2022 - 10.2023
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- 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.
- Tracked referral submission during facilitation of prior authorization issuance.
- Responded to inquiries from healthcare providers regarding prior authorization requests
Prior Authorization Specialist
Hartford Hospital Cancer Center
10.2019 - 03.2022
- Patient Service Representative for Medical Oncology from date range October 2019 to March 2021
- Input all patient data regarding claims and prior authorizations into system accurately.
- Check CPT codes to see if authorization is required for providers.
- Obtain authorizations for all imaging outpatient requests.
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow up is performed.
- Look through denials and submit appeals in bid to get them approved by insurance companies.
- Develop and implement prior authorization workflow, policies, and procedures.
- Secure patients’ demographics and medical information by using great discretion and ensuring that all procedures are in sync with HIPPA compliance and regulations.
Patient Service Representative
Starling Physicians
07.2018 - 10.2019
- Entered all patient data into electronic medical record within timely fashion from phone contract prior to patient meeting with physician.
- Answer phones in office as needed to respond to inquiries made by patients, vendors, insurance companies and other medical facilities.
- Triage calls to proper provider or department as necessary.
- Schedule and confirm patient appointments with patients and healthcare professionals.
- Observed strict confidentiality and safeguarded all patient-related information.
Front Desk Receptionist/Medical Records File Clerk
The Hand Center
09.2014 - 07.2018
- Schedule appointments with appropriate provider.
- Answer all incoming calls in timely manner.
- Collect copays and outstanding patient balances.
- Pulled patient charts for physicians to prepare physicians for appointments.
- Initiated patient medical records by creating and processing patient care record folder with patient demographics and medical history information.
- Maintained patient confidence by keeping patient records information confidential.
- Work as part of team in conjunction with clinical staff.
Education
Bachelor of Science - Human Services
Post University
Waterbury, CT10.2026
Completion Of Medical Assistant Program - Medical Assisting
Branford Hall Career Institute
Windsor CT09.2013
Skills
- Verbal and Written Communication
- Customer service
- Microsoft Office
- Understanding of insurance details
- Problem solving
- Active listening
- Time management
- Adaptability
- Self-Motivation
- Ability to work under pressure
Timeline
Procedure Scheduler
Connecticut GI
10.2023 - Current
Prior Authorization Specialist
Hartford Hospital Radiology
04.2022 - 10.2023
Prior Authorization Specialist
Hartford Hospital Cancer Center
10.2019 - 03.2022
Patient Service Representative
Starling Physicians
07.2018 - 10.2019
Front Desk Receptionist/Medical Records File Clerk
The Hand Center
09.2014 - 07.2018
Bachelor of Science - Human Services
Post University
Completion Of Medical Assistant Program - Medical Assisting
Branford Hall Career Institute
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