James M Parker

**** ******* **.

Columbus, OH ***28

380-***-****

Objective:

I desire a position where my talents and experiences can be best utilized for our mutual best interests and results..

Experience:

Senior OR Authorizations Specialist Ridgecrest Regional Hospital Ridgecrest, CA

October 2014 – January 2024

•Entered outpatient surgeries, wound cares, infusions & other various outpatient services in the computer.

•Verified patient eligibility both online & over the phone.

•Obtained prior authorizations & notifications as required by insurance online, over the phone, & by fax.

•Ran reports regarding those authorizations to ensure all authorizations were obtained prior to care being delivered. Once this process was started it made us more efficient as it resulted in fewer retro authorization requests from our billing department.

•Called patients with an expected balance to make arrangements to settle that balance prior to their procedure(s).

•Kept nursing staff and office staff updated on the progress of these authorizations for scheduling reasons.

•Scanned surgical/other outpatient services paperwork in the computer at the end of everyday

•Wrote and edited policies & procedures for anyone working this position in the future.

•Demonstrated excellent time management skills to accomplish all of the above tasks.

•Assisted uninsured qualified patients in obtaining Medi-Cal(California Medicaid).

Accounts Receivable Supervisor Engage Healthcare Business Services Columbus, OH

April, 2006- June 2010

•Responsible for overseeing billing and collections for multiple hospital based physician groups

•Answering phone calls and questions from staff, management, and insurance companies

•Mailed claims to the insurance companies along with any required information to process the claim such as records.

•Responsible for scheduling employee paid time off

•Responsible for tackling invoices that were 180 days or older in an attempt to collect payments. Collections increased 20% after I came onboard.

•Worked with several different department within and outside of the company to retrieve documents required for insurance companies to review in order to make a payment decision

•Appealed claims that were inappropriately denied

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