Authorization Representative Data Entry
Resume:
MIA A.
STANSIL
*********@*****.***
St. John, IN 46373
Results-driven professional with 20 years of experience and focus on performance. Results-driven and hardworking with top-notch communication and organization skills. Diligent and forward-thinking professional with attentive and team-oriented nature.
PROFESSIONAL SUMMARY
Community Healthcare System - Engagement Center
Scheduler/Prior Authorization Representative
Munster, Indiana • 06/2021 - Current
Pinnacle Hospital - Medical Records Clerk
Crown Point, IN • 02/2020 - 02/2021
WORK HISTORY
Contacted insurance companies to obtain prior
authorization for medical procedures.
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Tracked referral submission during facilitation of prior authorization issuance.
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Input all patient data regarding claims and prior
authorizations into system accurately.
•
Reached out to insurance carriers to obtain prior
authorization for testing and procedures.
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Verified eligibility and compliance with authorization requirements for service providers.
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Processed medical records requests from outside
providers according to facility, state and federal law.
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Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
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Reviewed charts and flagged incomplete or inaccurate information.
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Delivered charts to assigned areas of hospital by
following established routing procedures.
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• Uploaded physician progress notes, history and physicals SKILLS
• Authorizations
• Patient Scheduling
• Benefit Coverage
• Basic medical terminology
• Insurance authorization
• Proficiency in Epic
Effective communication
skills
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• Medical terminology
Understanding of insurance
details
•
Visitor and Customer
Relations
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Verbal and Written
Communication
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• Courteous and Professional
Multitasking and
Prioritization
•
Hammond High School
Hammond, IN • 06/2021
High School Diploma
Bryman College
Chicago, IL • 05/2021
EDUCATION
Certification: Dental
Laboratory Technology
Indiana University Northwest
Gary, IN • 05/2011
Certification: Unit Secretary
Community Care Network - Patient Registration
Representative
Merrillville, Indiana • 02/2019 - 02/2020
into electronic medical records.
Maintained patient confidence by keeping patient
records information confidential.
•
Created new medical records and retrieved existing medical records by gathering appropriate record folders and contents and assigning and recording new record numbers.
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Accurately pulled patient records for upcoming
appointments and procedures, typically within 8-hour period.
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Followed exact procedures for handling transfers and other releases of medical records.
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Explained financial responsibilities to patients as well as payment options and potential collection procedures imposed upon patients and other responsible parties.
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Collected payments and co-pays from customers using large variety of insurance programs, adjusting amounts based on specific plan directives.
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Accurately inputted patient and insurance information into company's computer system using Epic.
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Visited patients' rooms to collect insurance and financial information required for registrations.
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Set up patients in system by documenting key data, confirming eligibility and verifying insurance benefits.
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Scheduled Epic+ appointments using computerized
calendars in Epic System.
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Imaged and scanned patient and registration
documentation into electronic patient record via Epic.
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Identified non-participating and out-of-network
insurance plans and worked with patients and providers to address situations.
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Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
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Completed administrative patient intakes with case histories, insurance information and mandated forms.
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• Frequently double-checked patient histories and current information while scheduling follow-ups and other
appointments.
Carried out front office duties utilizing data entry skills in framework of medical database.
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Obtained payments from patients and scanned
identification and insurance cards.
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Accurately completed insurance and Medicaid billing and OASIS documentation for patient visits.
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Managed office logistics by scheduling appointments, maintaining files and collecting payments.
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Received, recorded and addressed incoming and
outgoing communication via telephone and email.
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Contact this candidate