Diane Nessinger

978-***-****

adzc5d@r.postjobfree.com

Northeast Hospital/Beverly Hospital

Authorization Coordinator June 2022 – January 2023

Work from four Advanced Image Work Ques (CT Scans, MRI, Nuclear Medicine, and Non Invasive exams) generated in the Epic system by date

Work all appointments in each work que by:

overifying all insurances in each appointment via the EPIC system or websites

ochecking that all listed coverage is in the correct order to be billed for the exam

ocreate or update referral record for each exam

overify whether or not an authorization is required for exam

ousing various authorization websites (NIA/Magellan, Evicore, AIM, United Healthcare)

ocontacting insurance company to verify authorization and dates are valid for each exam

ocontact physician’s office as needed for corrections to CPT codes, dates, and exam information

odocument all information obtain by use of smart phrases in the referral record

North Shore Physicians Group, Beverly, MA May 2021 – May 2022

Patient Access Representative

Create and manage schedule of daily appointments (DAR) for 3 providers, 2 primary care physicians and 1 endocrinologist.

oReview patient appointments for inactive insurances and COVID flags

oEnsure each appointment is scheduled correctly

oContact patient and refer to Patient Registration as needed

oInvestigate COVID Flags and ensure patient has no COVID symptoms prior to appointment.

Answer all incoming telephone calls via Finesse and Jabber Phone system.

Enter orders for prescription refills into the EPIC system, routing them to the appropriate provider.

Schedule follow up appointments or physicals.

Field sick calls to the appropriate Nursing Pool, using the appropriate Smart Phrase.

Review In Baskets. Schedule appropriate appointments requested by patients, route prescription refills to the correct prescription refill pool, or contact patient for help to their questions.

Check patient in for their appointment. Verify demographics, following COVID protocols, collect copayments if applicable, obtain patient signatures on consents, HIPPA, and other documents as needed.

Schedule new patient appointments for the Endocrinologist through the Endo Work Que by contacting each patient on the que via telephone.

Contact patients on the RAD Que to schedule radiology referrals, mammograms, bone density tests, CT scans, MRI’s, and other tested as requested by providers.

Reconcile the Cash Drawer in EPIC, checking that all copayments are accounted for.

Tobias & Battite Hearing Wellness, Beverly, MA October 2020 – April 2021

Patient Access Coordinator / Office Manager

Utilize Counsel Ear system to complete protocol for audiologist and hearing aid specialists

Answer all incoming calls

Enter demographics and insurance information into computer system for new patients and update for all existing patients

Follow strict COVID-19 protocols including obtaining and document temperatures for all persons entering the office, routine cleaning, and other tasks as needed

Schedule all appointments including:

ohearing exams with and without hearing aid evaluation, cerumen removal, hearing aid fittings,

oearmold fittings, ear mold scans hearing aid repairs, etc.

Obtain necessary referrals and medical clearance for all hearing tests/hearing aids appointments

Check in all patients upon arrival to our office including:

oscan all insurance card into computer system

oobtain all signatures required for treatment

Collect and process payments for hearing aids and other services

Collect mail, sort, and distribute to appropriate person

Unpack all hearing aids and ear molds delivered to the office

Enter serial numbers and warranty dates into Counsel Ear

Obtain a clean and safe office per DCE protocol

North Shore Ears, Nose & Throat, Danvers, MA September 2017 – October 2020

Front Desk Representative / Insurance Authorization

Utilize EPIC system to complete patient protocol for doctors including, but not limited to:

oChart Prep - Verify insurance for patients coming to the office and obtain referrals for the doctors as needed.

oEnter referrals into the system.

oCheck In - Check patients in upon arrival to the office, verify demographics and collect specialist copayments.

oCheck Out - Upon patient’s departure from office. Check patients out of the system and schedule return appointments or reminders.

Answer phones as needed and schedule patients for upcoming appointments.

Interface with patients, doctors, medical assistants, physician assistants and insurance companies to meet the needs of both the patients and the medical office.

North Shore Medical Center, Salem, MA January 1999 – October 2016

Birthplace Registrar / Insurance Authorization

Register patients; update demographic information and insurance information upon admission to the Birth Place.

Obtain authorization from various insurance companies for patients' admission.

Receive phone calls from various OBGYN offices to schedule various birthing procedures for patients. Enter all

appointments in Nurses' Book and Tempus (scheduling system). Update book and system daily.

Infusion Clinic Insurance Authorization: Run necessary reports Verify insurance and obtain authorization for each patient who has an appointment with the Infusion Clinic.

Masshealth Notification of Birth (NOB): Update newborn's name in hospital's computer system after discharge

from the facility. Complete NOB and Masshealth application and present to insurance company to obtain for

newborns. Keep track of applications.

Bed Placement Coordinator / Insurance Authorization

Use ethical judgment to complete bed assignments of all admissions and transfer patients in a prompt manner in

order to provide the best outcome for each patient while abiding by department procedures and protocols.

Insurance / Authorization

Verify insurance for emergency and surgery cases through various provider websites. Obtain information such as copayment and deductible. Obtain authorization and/or referral if required. Notify Financial Counselor with copayment and deductible information so they can notify patient. Upon completion, appropriately document information in ISGOLD and HURON.

Scheduling Coordinator

Schedule appointments for OT/PT Department and Florence Robertson Clinic (FRC).

Verify insurance coverage and obtain authorization/referrals for appointments. Maintain patients' charts according to hospital standards as needed.

Responsible for proper distribution of reports to patient and doctors for FRC clinic.

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