Front Office Referral Coordinator

AMBER L. PULSE

Charlestown, WV, *****

Phone: 304-***-****

Email: *********@*****.***

Objective: Oriented Front Office Supervisor and Insurance Referral Coordinator with a proven

track record of improving patient satisfaction and reducing waiting times in large healthcare

organizations. Skilled in streamlining referral workflows, implementing tracking systems, and

collaborating with medical staff to enhance communication and accuracy. Proficient at

coordinating with insurance companies to ensure timely authorizations and minimize claim

denials, resulting in high approval rates and improved patient compliance.

Dependable Administrative Coordinator and Medical Front Office member with over 10 years of

experience in business and medical office settings. Talented at supporting office operations and

physicians by coordinating and safely documenting patient and clientele information.

Friendly and helpful in patient and client interaction to improve satisfaction

ratings and patient & client loyalty.

PROFESSIONAL EXPERIENCE:

Office Supervisor & Authorization & Insurance Specialist (11/2024-Present)

Heart and Vascular Specialist – Leesburg, VA

● Recruit, train, onboard, and offboard employees

● Manage supplies and resources

● Implement and improve policies and procedures

● Arrange meetings and other schedules

● Arrange repairs and maintenance for facilities

● Maintain records and ensure compliance

● Lead projects and initiatives

● Work with management and staff to improve efficiency with weekly and monthly

meetings.

● Verifying insurance eligibility: Checking patient insurance details to confirm coverage for

requested services, including plan type, benefits, and eligibility status.

● Obtaining prior authorizations: Contacting insurance companies to request pre-approval

for specific medical procedures, medications, or treatments based on medical necessity

● Reviewing medical records: Analyzing patient medical history to ensure the requested

services align with their medical condition and insurance coverage.

● Communicating with providers and patients: Informing healthcare providers about

authorization requirements and updating patients on the status of their insurance

verification and authorization requests.

● Handling denials and appeals: Investigating denied claims, identifying potential issues,

and initiating appeals processes when necessary.

● Staying updated on insurance regulations Keeping updated on changing insurance

policies, coding guidelines, and billing requirements.

● Medical knowledge: Understanding basic medical terminology and disease processes to

interpret medical records

● Attention to detail: Accurately inputting patient information and insurance details to

avoid errors

● Problem-solving abilities: Identifying and resolving issues related to insurance coverage

and authorization processes

● Computer proficiency: Navigating electronic health records (EHR) systems and insurance

company portals

● Covering front desk and managing front

Insurance and Referral Coordinator (03/2021 – 11/2024)

Inova Primary Care Physicians – Purcellville/ Dulles South VA

● Ability to manage multiple responsibilities and prioritize tasks effectively in a fast-paced

environment.

● Verified patient insurance eligibility and benefits for initial patient intake.

● Developed and maintained relationships with insurance companies.

● Ensured that all patient information was kept confidential and secure.

● Prepared and submitted insurance claims.

● Resolved any claims issues with insurance companies.

● Processed insurance verifications for in a timely manner.

● Developed a system of tracking patient data to ensure accuracy and compliance with

HIPAA regulations.

● Verified patient eligibility for insurance coverage using Availity, Navinet, and other

web-based tools.

● Performed data entry and maintained accuracy of insurance policies in the system.

● Assisted patients with insurance enrollment and claims processing.

● Advised patients on insurance policies and benefits.

● Resolved discrepancies and disputes between insurance companies and patients.

● Provided technical assistance to staff members regarding insurance policies.

● Provided customer service to patients regarding insurance policies and coverage.

Medical Insurance Specialist/Registration Specialist (12/2016 – 03/2021)

WVU Medicine - Martinsburg, WV

● Received and verified patient information when they arrived

● Greeted and ensured patients were checked in within a timely manner

● Monitored the reception area and waiting room

● Ensured all patient information records were maintained and up to date

● Organized patients onto the patient board, processed armbands, and lab work labels

● Verified patient insurance policies

● Corresponding with insurance companies regarding insurance claims also inquired about

● authorizations for different therapies such as occupational therapy, physical therapy, and

speech therapy

● Managed front office duties by scheduling and maintaining therapist schedules through

being a timekeeper for the facility

● Documented file notes within the hospitals computerized systems

● Responded to incoming telephone calls

● Guaranteed sterile and non-sterile medical supplies were stocked accordingly to all

wards, clinics, and secondary locations

● Confirmed we were meeting our production goals by ensuring compliances

● Used Microsoft word, excel, and outlook along with verbal to communicate and collect

data

● Responsible for calculating and collecting copays

● Identified a need and gathered, organized, and maintained information

● Ensured proper card usage and conducted random account reviews

● Purchased office supplies along with other medical items that were needed though a

variety of vendors

● Resolved issues to ensure requests and bills were processed accurately and in a timely

mannered

● Maintained medical records and filing referrals from different doctors

TRAINING AND EDUCATION:

Certification in Nursing Assistant [CNA] (04/2016): Blue Ridge Community and Technical

College- Martinsburg, WV

Associate Science (AS) in Business Administration/Human Resources Management

(05/2014): Valley College- Martinsburg, WV

High School Diploma (05/1996):

Edgewood High School- Edgewood, MD

REFERENCE:

Name: Maura Lyons

Title: Office Manager/Supervisor – Inova Primary Care

Phone: 540-***-****

Name: Rhonda Cogswell

Title: Supervisor at WVU Medicine

Phone: 304-***-****

Name: Brenda Allen

Title: Director at Berkeley Medical Center

Phone: 304-***-****

Contact this candidate