Authorization Specialist Intake
Resume:
WORK EXPERIENCE
Medical Assistant/Scheduler
The LCADA Way - Elyria, OH
April 2019 to Present
• Coordinate scheduling and referrals for medical services for medical provider and other assigned clinical staff.
• Daily data entry of medical appointments, special instructions, patient information, medications etc.
• Weekly medication inventory tracking. Ordering and delivery of client medications for re-occurring monthly appointments.
• Prepare, generate and update appropriate medical records with current insurance information, co-pays or grant funded assistance for medications.
• Daily confirmation of all on-site clinic appointments.
• Assist with maintaining and updating of all client addresses and phone numbers.
• Receive incoming correspondence and review/forward to appropriate clinical staff.
• Receive, screen, coordinate or resolve concerns with telephone calls from clients, pharmacies, other healthcare providers etc.
• Prepare lab orders, release of information and all other forms as requested by medical provider and/or clinical staff.
• Perform a variety of administrative duties including but not limited to: making and answering phone calls, faxing, filing and scanning of client confidential documentation.
• Provide excellent customer service to all internal and external customers.
• Assist all clients who come into the clinic, with questions or concerns and booking future appointments.
• Call clients to remind them of upcoming appointments, make changes as necessary and coordinate schedules with medical provider.
• Follow up with patients to ensure satisfaction and quality of care Intake/Billing Specialist
OhioGuidestone - Lorain, OH
February 2018 to April 2019
• Direct contact with referral sources and clients.
• Referral intake and data entry of client demographics, benefits and program enrollment.
• Identify and enter client program placement.
• Verify & re-verify client insurance eligibility & benefit coverage.
• Update and maintain client benefit payors appropriately ie. Private insurance, Medicare, Medicaid, grants and funding. KATHLEEN
RIVERA
Elyria, OH 44035
********.**@*****.***
I possess strong interpersonal skills and I am able to work well with diverse groups of people. My strong organizational skills and capability to learn new tasks quickly prepares me to meet deadline expectations. I am capable of working independently and as part of a team.
• Determine financial eligibility for special funding assistance.
• Assists in claims denials.
• Process client copays.
• Coordinate & maintain daily client scheduling for Assessors.
• Provide daily assistance to referral sources and staff relating to client status, benefits, worker assignments etc.
• Provide departmental reports.
Authorization Specialist
NeuroSpinecare, Inc - Sheffield Village, OH
February 2016 to March 2017
• Verify insurance eligibility & benefit coverage.
• Request authorization for surgical procedures.
• Review clinical documentation to ensure insurance criteria requirements are met.
• Direct contact with insurance and managed care representatives for patient verification and authorization purposes.
• Patient scheduling and assistance.
Intake Specialist
Foresight Medical Company - Tampa, FL
May 2015 to December 2015
• Data entry of UB04, HCFA, Diagnosis, CPT & HCPCS Codes.
• Entry of Manufacturer invoices, implant logs and revenue codes.
• Required preparations needed for implant charge review for Workers Comp claims. Charge Review Specialist
Cornerstone Healthcare - High Point, NC
November 2012 to February 2015
• Timely & accurate charge review and submissions.
• Charge review captures.
• Proper CPT coding, sequencing of diagnosis's & procedure charges by following coding guidelines for reimbursement purposes.
• Integration of coding & insurance reimbursement in charge review process.
• Ensure accuracy of charges.
• Charge encounter follow-up & resolution.
• Daily provider schedules and reports for tracking charge entries, unassigned payments and patient services provided.
Check In/Out Rep
Cornerstone Healthcare - High Point, NC
November 2010 to November 2012
• On the job training for Phlebotomy and Medical assisting.
• Administrative support to physicians and assist clinical staff with blood draws, vital signs, insertion of intravenous catheters, supply set up and medication needed for IV therapy.
• Perform insurance verification and authorization.
• Maintain an organized system for tracking patients with IV therapy services.
• Inform patients of up to date insurance requirements, treatment plans, and fees, while staying up to date on insurance requirements.
• Prepare and attach all required claims documentation including referrals, treatment plans, and other required correspondence to reduce denials.
• Scheduling patient appointments, confirming patient information, collecting copays, and verifying insurance.
• Responsible for ordering supplies and medication for the infusion center. EDUCATION
None in Secretarial Science
Lorain County Community College - Elyria, OH
September 1983 to June 1984
Southview High School - Lorain, OH
1983
SKILLS
Billing (10+ years)
claims (5 years)
Filing (10+ years)
Receptionist (10+ years)
Accounts Receivable (5 years)
Data Entry (10+ years)
Customer Service (10+ years)
Scheduling
Medical Records
EMR
Word
Time Management
coding
Outlook
ADDITIONAL INFORMATION
SKILLS:
• Knowledgeable in billing process of Private/Commercial, Medicare, Medicaid & Managed Care insurances.
• Electronic Medical Records
• ICD-9/ASC/CPT/HCPCS Coding
• Medical billing & coding for a variety of specialties.
• Team Player with positive attitude and strong work ethic.
• Maintains strict confidentiality and exercises good judgment.
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