Prior Authorization Customer Service

Jennifer Stennis

Crowley, TX

Professional Summary

Dedicated Prior Authorization coordinator with 4 years of experience in medical scheduling, patient care, and insurance verification. Proficient in ICD-9 and ICD-10 coding, medical billing, and medical records management. Proven in providing excellent customer service and ensuring patient safety. Seeking a remote or hybrid role utilizing my skills in prior authorization coordination. Willing to relocate: Anywhere

Work Experience

Home Health Aide (HHA)

BLOSSOM HOME HEALTHCARE-Dallas, TX

September 2020 to December 2024

Assist clients with daily personal tasks which can include Light housework, bathing, grooming, dressing, feeding, exercising, and administering medication under the direction of a registered nurse or therapist, Diagnostic Scheduler

MAXIMUS Inc.-Remote

November 2022 to November 2024

• Referrals Requested

• Gathering invoices to submit to Billing

• Responsible for requesting results to be uploaded

• Responsible for scheduling diagnostic appointments for veterans within time and distance guidelines set by the VA,

• Working to find and negotiate appointments that are the most convenient for veterans as far as date and time of service and distance traveled

• Communicating with facilities to ensure they have all necessary veteran information, pertinent billing information

• Make sure the Doctor credentialing information pertaining to VES and its affiliates. Patient Benefits Coordinator

South Texas Oncology and Hematology-Fort Worth, TX January 2020 to March 2022

• Prior Authorization

• Assist Patient with all billing inquiries

• PAP/patient assistant programs

• Verified insurance information

• Update all personal information

• Notified doctor

• Chart preparation

• Calling and keeping patients notified of any change made to account.

• Clearance to start treatment

• ICD 9 and 10 coding

• Referral obtained

Prior Authorization Coordinator

TEXAS PAIN INSTITUTE-Fort Worth, TX

July 2019 to January 2020

• Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety

• Ensure complete and accurate registration, including patient demographic and current insurance information

• Assemble information concerning patient’s clinical background and referral needs

• Provide appropriate clinical information to specialist

• Contact review organizations and insurance companies to ensure prior approval requirements are met

• Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians.

• Review details and expectations about the referral with patients

• Referral Coordinator

Skills

• ICD-9 (7 years)

• Medical Scheduling (4 years)

• Epic (4 years)

• Auditing (4 years)

• Patient Care (10+ years)

• Analysis skills (4 years)

• Financial Services (2 years)

• Quality control (4 years)

• ICD-10 (7 years)

• Customer service (10+ years)

• Transcription (2 years)

• Anatomy Knowledge (4 years)

• Medical Coding (4 years)

• Vital Signs (4 years)

• Data Entry (7 years)

• ICD Coding (7 years)

• Clerical Experience (4 years)

• Medical Billing (4 years)

• Quality Assurance (3 years)

• Medical Records (7 years)

• Medical Office Experience (7 years)

• Medical Terminology (7 years)

• Insurance Verification (4 years) (4 years)

• Phone Etiquette (10+ years)

• HIPAA (10+ years)

• CPT Coding (10+ years)

• Claims Adjuster (Less than 1 year)

Certifications and Licenses

CPR Certification

Additional Information

• Life and health Insurance License

• Insurance Claims Adjustor License

• Notary Public License

Contact this candidate