Prior Authorization
Resume:
REBECCA SCHULTZ
PRIOR AUTHORIZATION SPECIALIST SPECIALTY FUNDING COORDINATOR VITREORETINAL TECHNICIAN
Weston, WI Cell: 920-***-**** Email: ad5u8z@r.postjobfree.com
PROFESSIONAL SUMMARY
Highly skilled and dedicated healthcare professional with extensive experience in various roles within ophthalmology clinics and healthcare facilities. Proven track record in delivering exceptional patient care, managing administrative tasks, and facilitating smooth clinic operations. Adept at coordinating surgical procedures, obtaining prior authorizations, and ensuring compliance with insurance requirements. Proficient in conducting ocular assessments, performing diagnostic tests, and administering medications under physician direction. Excellent communicator with a talent for building rapport with patients, colleagues, and stakeholders. Committed to providing compassionate care and optimizing patient experiences.
SKILLS
Prior Authorization Medical Documentation Patient Education Surgical Coordination
Insurance Verification Patient Communication EMR Management Clinical Coordination
WORK EXPERIENCE
PRIOR AUTHORIZATION/RETINAL TECHNICIAN March 2017 – Present
Northeast Wisconsin Retina Associates
●Obtained referrals and prior authorizations for injections and surgeries, ensuring timely access to necessary treatments.
●Secured funding for specialty pharmacy medications, optimizing patient care pathways.
●Initiated accurate documentation of patient history, chief complaints, and ocular findings, ensuring comprehensive medical records.
●Conducted various diagnostic tests, including visual acuity measurements and OCTs, aiding in precise diagnosis and treatment planning.
●Administered topical and oral medications under physician guidance, ensuring proper patient care.
●Assisted with intraocular injections, laser treatments, and other procedures, contributing to efficient clinic operations and patient comfort.
CLINIC COORDINATOR December 2014 – March 2017
Northeast Wisconsin Retina Associates
●Optimized schedules for all 4 clinic locations and physicians.
●Organized surgical coordination between physicians, hospitals, and clinic locations.
●Prepared surgical orders and preoperative instructions for physicians, hospitals, and patients.
●Evaluated insurance eligibility, benefits, and obtained referrals and prior authorizations.
●Determined services that were non-covered and obtained an ABN from the patient.
●Contributed to collections and applications for financial assistance, relayed key financial and insurance information between front office and business office staff.
●Managed medical administrative assistants and coordinated the tasks assigned below.
MEDICAL ADMINISTRATIVE ASSISTANT October 2012 – December 2014
Northeast Wisconsin Retina Associates
●Entered, assessed, and maintained current insurance, demographic, and financial information accurately into practice management and electronic medical records software.
●Evaluated insurance eligibility, benefits, and obtained referrals and prior authorizations.
●Determined services that were non-covered and obtained an ABN from the patient.
●Scheduled appointments and surgeries.
●Tracked neonatal ICU appointments, missed appointments, and broken treatment schedules.
●Collected copays and balances due, assisted with applications for financial assistance.
●Prepared electronic medical records, related correspondence, and medical record requests.
PATIENT ACCOUNT REPRESENTATIVE September 2011 – October 2012
Aurora Health Care
●Managed accurate input and upkeep of insurance, demographic, and financial data in EMR systems, ensuring data integrity.
●Provided courteous and efficient assistance to patients and visitors, directing inquiries, and facilitating check-in procedures.
●Resolved patient queries regarding accounts, screened calls, and ensured thorough completion of necessary forms.
●Collected payments, updated registration details, and arranged payment plans, advising patients on available financial options.
CUSTOMER SERVICE REPRESENTATIVE FLOAT June 2005 – September 2011
Aurora Health Care
●Negotiated and established payment plans.
●Delivered support to the department by greeting and registering patients, completing all necessary forms, and obtaining demographic and insurance information from the patient.
●Collected patient co-pays, posted payments, and updated patient file information.
●Contributed as the point of contact for patients and visitors when they enter the clinic.
PROFESSIONAL DEVELOPMENT
JCAHPO Certified Ophthalmic Assistant Oct 2022
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