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Medical Assistant Prior Authorization

Location:
Las Vegas, NV
Salary:
20.00
Posted:
April 03, 2024

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Resume:

Sabrina Newson

702-***-**** • ad4rpu@r.postjobfree.com • Las Vegas, Nevada 89107

Highly organized experienced Medical Assistant with over 10 plus years of experience of front and back office procedures Knowledgeable in both clinical and administrative functions in Family Practice, Pediatrics, Neurology, Urology and Laboratory and Pain Management Competent in patient admissions, assisting physicians, collecting co-payments, pharmacy calls and patient charting Ability to work in fast paced environments with multiple doctors and physicians

Summary

10/2020 - Current

Prior Authorization Specialist, Nevada Pain Care, Las Vegas, NV Experience

Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.

• Proofread documents carefully to check accuracy and completeness of all paperwork. Clarified patient inquiries and questions to update patient account information in computer system.

Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.

• Maintained files for referral and insurance information, entering referrals into system. Performed detailed medical reviews of prior authorization request, following established criteria and protocols.

• Scheduled patient appointments, diagnostic specialty appointments, tests and procedures. Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.

Determined which party would be liable for payment on medical services by thoroughly reviewing patient insurance coverage.

• Informed applicants of other agencies providing useful or related assistance.

• Answered questions and responded to inquiries to deliver high level of service to patients.

• Explained eligibility details and affordability options to patients with kindness and respect. Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.

Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.

• Notified ordering providers of denied authorizations.

• Maintained positive working relationship with fellow staff and management. Used [Software] to input claim, prior authorization and other important medical data into system.

Conducted interviews with applicants, explaining benefits process and which programs were available.

• Collaborated with internal departments to provide account status updates. Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.

Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.

• Coordinated resolutions for issues and appealed denied authorizations. 12/2019 - 10/2022

Back Office Medical Assistant, Nevada Spine Clinic, Las Vegas, NV 01/2007 - 01/2009

Back Office Medical Assistant, Women's Cancer Center, Las Vegas, NV

• Center for Wellness And Pain Care

• Back office duties including triage

• Injections.referrals

• Pump interrogation for pump refills

• PRP Prep for injection Therapy

• Patient rx refills

• Med Auths

• Medication prep for Botox Injections

• EMR

• Aprima

• Biometric Screener, Body fat composition using an Omron device:

• Performed manual BP

• Finger sticks for glucose, cholesterol and triglycerides:

• Recording of Patient height, weight and waist measurement:

• Assessed, documented and monitored vital signs for patients within outpatient setting.

• Scheduled appointments for patients via phone and in person.

• Educated patients about medications, procedures and physician's instructions. Secured patient information and maintained patient confidence by completing and safeguarding medical records.

• Organized charts, documents and supplies to maintain team productivity.

• Documented notes during patient visits.

Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.

Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.

• Followed principles of asepsis and infection control to meet patient safety guidelines.

• Measured vital signs and took medical histories to prepare patients for examination.

• Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.

• Incorporated outside records into charts and EHR.

• Collaborated with local pharmacies to resolve and clarify issues with patient medication. Participated in team meetings to improve workflows and contribute to improving patient population outcomes.

• Responded to patient callbacks and phone-in prescription refill requests.

• Cleaned and maintained medical equipment following procedures and standards.

• Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.

• Administered rapid tests for COVID and strep to help clinical staff assess conditions.

• Performed preliminary physical tests to accurately record results in patient history summary. Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.

• Conducted insurance verification and pre-certification and pre-authorization functions.

• Contacted pharmacies to submit and refill patients' prescriptions.

• Labeled and completed lab requisitions using ICD and CPT coding.

• Assisted physician with physical exams and set ups for minor procedures and wound care

• Imputed and maintained EMR charting system

Performed other duties including, injections and catheter changes and placements, vitals and appointment scheduling

• Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.

• Assisted with diagnostic testing by collecting and packaging biological specimens for internal 02/2015 - 10/2021

Back and Front Office Medical Assistant, Center For Wellness And Pain Ca, Las Vegas, NV

and laboratory analysis.

Secured patient information and maintained patient confidence by completing and safeguarding medical records.

• Organized charts, documents and supplies to maintain team productivity.

• Incorporated outside records into charts and EHR. Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.

• Measured vital signs and took medical histories to prepare patients for examination.

• Followed principles of asepsis and infection control to meet patient safety guidelines.

• Responded to patient callbacks and phone-in prescription refill requests. Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.

• Cleaned and maintained medical equipment following procedures and standards.

• Performed preliminary physical tests to accurately record results in patient history summary.

• Documented notes during patient visits.

• Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.

• Labeled and completed lab requisitions using ICD and CPT coding.

• Educated patients about medications, procedures and physician's instructions. Performed a variety of procedures including: patient triage, prescription writing, vitals and pharmacy verifications

• Provided procedure set up for Med Tronic

• Received inbound calls and made outbound calls to patients and vendors Completed front office duties including: patient check in/check out, collecting co-payments batch out at end of day, scheduling patient appointments and filing and charting.

Secured patient information and maintained patient confidence by completing and safeguarding medical records.

• Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.

• Set up, cleaned and stocked examination rooms with medical supplies.

• Assisted patients with registration, new patient paperwork and check-out process.

• Educated patients about medications, procedures and physician's instructions.

• Performed preliminary physical tests to accurately record results in patient history summary.

• Organized charts, documents and supplies to maintain team productivity. Guided patients to room, recorded vital signs, discussed patient medical history and entered information for physician or other clinical staff to review.

• Closed and submitted patient insurance claims at end of shift. Prepared daily charts by creating and updating electronic health records system data prior to patient visits.

• Responded to patient callbacks and phone-in prescription refill requests.

• Incorporated outside records into charts and EHR.

• Labeled and completed lab requisitions using ICD and CPT coding.

• Measured vital signs and took medical histories to prepare patients for examination. Participated in team meetings to improve workflows and contribute to improving patient population outcomes.

Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.

• Assessed, documented and monitored vital signs for patients within outpatient setting. Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.

• Maintained inventory, vaccination and product expiration logs to record updated 11/2001 - 11/2008

Back Office Medical Assistant, LV Urology, Henderson, NV 01/2002 - 01/2008

Back Office Medical Assistant, Urology Specialist Of Southern Nevadaada, Las Vegas, NV

documentation for tracking purposes.

• Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.

• Administered rapid tests for COVID and strep to help clinical staff assess conditions.

• Scheduled appointments for patients via phone and in person.

• Collaborated with local pharmacies to resolve and clarify issues with patient medication.

• Followed principles of asepsis and infection control to meet patient safety guidelines.

• Cleaned and maintained medical equipment following procedures and standards.

• Conducted insurance verification and pre-certification and pre-authorization functions.

• Supervised, trained and coached team of medical assistants.

• Documented notes during patient visits.

Scheduled patients by collecting screening information or presented nurse with clinical information to triage urgent patient needs.

• Contacted pharmacies to submit and refill patients' prescriptions. Executed patient triage procedures, injections, phlebotomy, bladder irrigations and ultrasounds

• Responsible for catheter changes and placements, urinalysis and daily controls in labs

• Imputed and maintained EMR charting system

• Performed additional duties as needed including urology testing as required by M.D

• Collaborated with local pharmacies to resolve and clarify issues with patient medication.

• Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.

• Administered rapid tests for COVID and strep to help clinical staff assess conditions. Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.

Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.

Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.

• Cleaned and maintained medical equipment following procedures and standards.

• Scheduled appointments for patients via phone and in person.

• Responded to patient callbacks and phone-in prescription refill requests.

• Followed principles of asepsis and infection control to meet patient safety guidelines.

• Assessed, documented and monitored vital signs for patients within outpatient setting.

• Performed preliminary physical tests to accurately record results in patient history summary.

• Documented notes during patient visits.

• Labeled and completed lab requisitions using ICD and CPT coding. Participated in team meetings to improve workflows and contribute to improving patient population outcomes.

• Educated patients about medications, procedures and physician's instructions.

• Interviewed and engaged patients to obtain medical history, chief complaints and vital signs. Performed duties such as blood draws, wound care, catheters changes and placements, bladder ultrasounds, urology testing, urinalysis and lab testing, patient triage and bladder irrigations

Performed additional duties as needed including patient call backs, pharmacy calls, medication authorizations and assisting physician with procedures

• Collaborated with local pharmacies to resolve and clarify issues with patient medication.

• Prepared treatment rooms for patients by cleaning surfaces and restocking supplies. Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.

Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.

• Organized charts, documents and supplies to maintain team productivity. Secured patient information and maintained patient confidence by completing and safeguarding medical records.

• Incorporated outside records into charts and.

• Measured vital signs and took medical histories to prepare patients for examination. Medical Assistant Diploma, Abdministrative Assistance and Secretarial Science Nevada Career Institute, Las Vegas, NV

Eldorado High School Diploma

Education And

Training



Contact this candidate