BERNICE NELSON

ad2nqt@r.postjobfree.com 619-***-**** Menifee, CA 92584

Summary Qualifications include more than 14 years' experience and knowledge in Health Care industry with a focus on Customer Service and Administrative Support. Currently working towards obtaining my Medical Administration Certification. I offer over 1 year processing Medical Authorizations within a Call Center environment, and a combined 11 years in a Urgent Care as well as an ER setting registering patients. Able to remain poised under demanding situations, self-confident and levelheaded, work well independently as well as with others, am able to take criticism well but above all am hard working.

Skills EPIC, Citrix, IDX, EZCap, EZNet, Cisco,

Documentation and Paperwork

Recordkeeping and Data Input

Telephone Etiquette

Proficient in Tagalog

Authorizations Knowledge

Effective Communication Skills

Appointment Scheduling

Documentation and Reporting

Data Entry

Critical Thinking

Dependable and Responsible

Experience Authorization Specialist/Customer Service Answering 03/2011 - 12/2023 Rady Children's Hospital San Diego, CA

40 plus inbound and outbound calls from Provider's offices, Insurance Providers, and Members and assist in resolving issues in a timely manner. Verification of Insurance Benefits based on Medi-Cal guidelines for specific and limited services including inpatient/outpatient, out of network services as well as DME services Screens and prioritizes 30+ incoming Prior Authorization requests, reviews clinical notes to determine how to processes incoming requests, including completing the authorization for specific and limited services, based on established guidelines Forwarding authorization requests that require clinical judgment from a Nurse or Medical Director for further review while meeting or exceeding designated turn-around time-frames. Patent Service Representative 04/2005 - 03/2008

Sharp Health Care

Registering 20-30 patients for both inpatient and outpatient procedures, verify Insurance and eligibility in order to process patient referrals in a timely and accurate manor into the Epic EMR system

Collecting patient co-payments and verify billing information Balance and secure cash drawer, prepare daily deposits following established cash receipt procedures

Responsible for preparing and managing daily/weekly schedules as well as verifying the accuracy of daily reports

Scheduling appointments, follow-up appointments and confirming patient information And provide daily office support while helping to maintain supply levels and ensure general work flow.

B

N

Education and

Training

Surgical Tech Diploma: Healthcare 01/2010

Concord Career College San Diego, Ca

Some College (No Degree): Prerequisites

Grossmont Community College San Diego, Ca

Certifications Medical Terminology Certified, CPR & AED Certified (2020 References Professional Reference All professional references provided upon request.

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