Hardworking former Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 22 years of managing documentation. Considered a team player with exemplary multitasking and communication skills.
Cooperative Correspondence Clerk with 19 years of experience. Adept at customer service and staying client focused through conflict resolution. Exceptional customer service skills and accurate typing ability.
Resourceful Medical Receptionist/Referral Coordinator adept at keeping office operations smooth and efficient. Detail-oriented approach to organizing files, scheduling appointments and assisting patients. Brings background in medical office settings over 22 years to handle patient needs.
Skills
Proficiency in Microsoft Office
Physician order verification
Preauthorization obtainment
Claim research
Issue resolution
Effective communication skills
Digital filing
Customer inquiries
Data entry
Customer service
Payment collection
Payment processing
Strong presentation skills
Regulatory compliance
Managing deadlines
Front desk operations
HIPAA guidelines
Referral verification
Patient callbacks
Records maintenance
Records management
Telephone etiquette
Microsoft Office
Time management
Reliable and trustworthy
Working collaboratively
Critical thinking
Clerical
Friendly, positive attitude
Experience
08/2020 to 01/2021
Medical Receptionist/Referral CoordinatorDana-Farber Cancer Institute – Londonderry, NH,
Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services.
Answered phone calls to provide assistance, information and medical personnel access to maximize office efficiency.
Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
Supported administrative and healthcare staff, providing order fulfillment and inventory management services to ease operations.
Observed strict HIPAA guidelines at all times according to company policy.
Set up appointments for physician visits and procedures using calendar software.
Pleasantly greeted each patient and offered the desk sheet for easy sign-in.
Answered multi-line phone system and directed callers to requested personnel and departments.
Updated group medical records and technical library to support smooth office operations.
Compiled physical and digital documents, charts and reports to meet business and patient need.
Prepared and sent financial statements to support bookkeeping functions.
Informed patients of financial responsibilities prior to rendering services.
Communicated with all partners throughout practice, including physicians, nursing staff, technicians and medical assistants.
Delivered high-quality administrative and customer service to sustain patient and work flows.
Greeted callers with enthusiasm, answering all phone calls by second ring.
Straightened up waiting room to maintain neat and organized space.
Processed patient payments and scanned identification and insurance cards.
Took messages from patients and promptly relayed to appropriate staff.
Conducted patient intake interviews to collect medical information and insurance details.
Entered patient information, including insurance, demographic and health history into system to keep all records up-to-date.
03/2016 to 12/2019
Prior Authorization SpecialistSIMEDHealth – City, STATE, SIMEDHealthoftware to schedule and manage patient appointments.
12/1999 to 12/2015
Assistant Manager & Referral CoordinatorPhysicians Care – City, STATE,
Supervised and evaluated staff of 8 including other assistant managers, enabling them to improve skills, achieve daily objectives and attain advancement.
Advanced to keyholder and assistant manager-in-charge in manager's absence.
Generated repeat business through exceptional customer service and responded to customer concerns with friendly and knowledgeable service.
Set and enforced policies focused on increasing team productivity and strengthening operational efficiency.
Submitted reports to senior management to aid in business decision-making and planning.
Supported staff development and goal attainment by focusing on skill development and job satisfaction.
Monitored employee performance and developed improvement plans.
Offered hands-on assistance to patients, assessing needs and maintaining current knowledge of patient preferences.
Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
Monitored cash intake and deposit records, increasing accuracy and reducing discrepancies.
Established and optimized schedules to keep coverage and service in line with forecasted demands.
Kept work areas clean, organized and safe to promote efficiency and team safety.
Maintained positive patient relationships by responding quickly to customer service inquiries.
Handled patient service by dealing with complaints, organizing stock and answering patient questions.
Supervised team of 8 employees and provided feedback on performance.
Helped with planning schedules and delegating assignments to meet coverage demands.
Developed and managed employee schedules, balancing individual requests and requirements with business needs.
Onboarded new employees, including training, mentoring and new hire documentation.
Assisted Manager in interview process of prospective employees and provided feedback.
Weighed patient need, provider availability and insurance coverage to determine optimal scheduling.
Called insurance companies to get precertification and other benefits information on behalf of patients.
Trained 3 staff on referral and intake process.
Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
Preserved and prepared reports and treatment records.
Provided ongoing counseling to help patients deal with conditions and processes
Documented case notes daily and coordinated follow-up for seamless case management.
Organized clinical documentation, treatment plans, and referrals.
Coordinated program referrals for community-based resources.
Operated with high integrity, built trust, and earned sustained credibility with internal and external clientele.
Developed standard operating procedures and document workflows for current and future process steps.
Partnered with cross-functional teams to conduct thorough discovery and due diligence on existing processes.
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.
Education and Training
Expected in
High School Diploma: Ed White High School - Jacksonville, FL, GPA:
Websites, Portfolios, Profiles
https://www.facebook.com/Jessica.Claire.7
Additional Information
Volunteer at Camp Blanding World War Museum as a Living Historian for 15 years.
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