Pre-Authorization & Schedule Coordinator

Valerie Walker

**** ********* **** *********, ******** 21218 C: 443-***-**** **************@*****.***

Objective

To obtain a position where I can utilize my outstanding customer service skills to effectively service my coworkers and clients.

Education

STRAYER BUSINESS COLLEGE, BALTIMORE, MARYLAND 1989

Diploma of Completion – Business/Modern Secretary

DUNBAR SENIOR HIGH SCHOOL 1982

High School Diploma – General Subjects

Experience

Kforce (Agency) - Baltimore, Maryland – October 2018 to Present:

Medstar Union Memorial Hospital (Pre-Authorization Specialist)-

- Communicated and translated procedure and diagnosis codes with various insurance companies

- retrieved and reviewed clinical notes from IDX Web/EMR

- read and faxed clinical notes, MRI and radiology reports for review

- reviewed posting sheets for proper CPT and diagnosis codes to coincide with procedure

- maintained a daily spread sheet to ensure overall accuracy

- updated patient demographic and insurance information

- informed insurance companies of cancelled or rescheduled surgery dates

- communicated with billing staff on surgery benefits and authorizations

- communicated with the physician offices regarding denials to suggest a peer to peer option

- scan approval letters after completing the authorization process

Kennedy Krieger Institute (Insurance Verification Specialist)-

- Obtained benefits and authorizations from various insurance companies

- generated and faxed referral request to PCP offices

- made follow-up calls to obtain referrals

- communicated to the physician offices on the status of referrals and authorizations

- separated and distributed incoming faxes to other team members

- entered appropriate notes in the system for billing and staff member’s awareness

- request interpreters

- scanned completed referral and authorizations into the system

University of Maryland Medical System- Baltimore, Maryland - September 1997 to February 2018: (Pre-Authorization & Scheduling Coordinator)

- obtained insurance benefits and authorizations - checked in/checked out patients

- reviewed & faxed pre-ops, clinical notes from EPIC/ EMR - researched claims inquiries

- scheduled appointments including double bookings - call center operator - requested lab results - collected co-pays

- reviewed and distributed incoming mail - resolved patient’s conflicts

- up-loaded prescription refills - ordered supplies - requested interpreters

Accomplishments

- Assisted deaf/hearing impaired patients with my sign language skill

- Successfully completed 8 hours of training in the Non-Violent Crises Intervention

Program

- Received several certificates for monthly training programs for customer service:

a.) Power of Perception

b.) Drama Triangle

c.) Gratitude & Attendance

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