Yuronda Shepard
Hollywood
Summary
Lead Authorization Coordinator at Gastro Health with a proven track record in enhancing patient care through efficient prior authorization processes. Leveraging strong communication and critical thinking skills, I improved operational efficiency and fostered teamwork, resulting in increased customer satisfaction and streamlined referral management. Committed to upholding healthcare regulations and patient confidentiality.
Overview
25
25
years of professional experience
Work History
Lead Authorization Coordinator/Billing Specialist
Gastro Health
04.2000 - Current
- Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Served as a liaison between primary care physicians, specialists, and patients to ensure timely access to needed services.
- Contributed to development of referral policies and procedures, ensuring compliance with healthcare regulations.
- Scheduled surgeries, managed pre-certifications and verified insurance coverage.
- Calculated estimated copay based on current insurance benefits.
- Reviewed authorizations from payer to determine approved or denied items.
- Submitted for prior authorization with required documentation to appropriate funding source.
- Increased efficiency in handling authorization cases through effective prioritization based on urgency and complexity levels.
- Researched and resolved billing discrepancies to enable accurate billing.
- Processed referral requests from patients, doctors and other health care professionals.
- Responded to patient inquiries to offer timely updates regarding referral status.
- Improved customer satisfaction with prompt and clear communication regarding their billing inquiries.
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
- Developed rapport with customers through empathetic listening skills, creating positive experiences even during difficult conversations.
- Delivered prompt service to prioritize customer needs.
- Provided one-on-one mentoring to help individuals reach their full potential within the organization.
- Mentored new hires, resulting in stronger staff development and increased productivity.
- Advanced organizational goals through strategic development of training initiatives aligned with company objectives.
- Scheduled, coordinated and confirmed appointments and meetings.
- Managed high-volume phone calls, directing inquiries to appropriate personnel for prompt resolution.
- Handled sensitive customer information with confidentiality, adhering to company privacy guidelines.
- Developed strong working relationships with team members, fostering a positive work environment.
- Completed all tasks in compliance with company policies and procedures.
- Assisted in the development and implementation of company-wide policies related to referral coordination operations.
- Resolved complex referral issues promptly, minimizing disruptions in patient care and maintaining positive relationships with providers.
- Managed a team of referral coordinators, providing guidance and support for optimal performance and professional growth.
- Weighed patient need, provider availability, and insurance coverage to determine optimal scheduling.
Education
Medical Office Management
Concorde Career College
High School Diploma -
Hallandale High School
HallandaleSkills
- Prior authorization
- Strong communication skills
- Organizational growth
- Critical thinking
- Effective time management
- Professionalism and ethics
- Patient confidentiality compliance
- Healthcare regulations
- Teamwork
- Problem-solving
Timeline
Lead Authorization Coordinator/Billing Specialist
Gastro Health
04.2000 - Current
Medical Office Management
Concorde Career College
High School Diploma -
Hallandale High School
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