Medical Referral Specialist Resume Example
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MEDICAL REFERRAL SPECIALIST
Professional Summary
A dedicated and proactive Referral Specialist, specializing in Insurance referrals, authorizations, clinical reimbursement, and overall quality patient care, start to finish. Organized professional who works well with a team as well as independently. Versatile Administrative professional well-versed in healthcare practices, compliance standards and operations. Excellent problem-solver and clear communicator with positive and upbeat personality.
Skills
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Work History
Medical Referral Specialist, 07/2018 to Current
Jp Recovery – Rocky River , OH
Jp Recovery – Rocky River , OH
- Received, recorded and addressed incoming and outgoing communication via telephone and email.
- Answered phone calls and messages for 60,000 patients, 50+ physician's at a primary care medical facility, scheduling specialty appointments and handling patient inquiries.
- Successfully scheduled patient appointments and placed reminder calls to ensure exceptional customer experience.
- Facilitated organized record retrieval and access by maintaining filing system for both in-house and out-side.
- Specializing in Insurance Referrals, Prior Authorizations, and updating patients insurance information when needed.
- Schedule all outside diagnostic testing
- Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
Lead Receptionist, 08/2016 to 06/2018
Exos – Phoenix , AZ
Exos – Phoenix , AZ
- Responsible for all Physical Therapy insurance referrals, authorizations, eligibility, patient registration, insurance verification's, log all Medicare POC, keep track of visits and benefit policies for each and every patient.
- Directly deal with difficult, upset, or confused patients in the most dignifying, professional, and compassionate manner.
- Work directly with the billing department to ensure accurate reimbursements and clinical documents are being submitted in a timely manner.
- Responsible for updating and training the receptionist with the most current insurance information, policies and procedures, and changes for all specialties and family practice.
- Collect copay's, bad debt, balances, and logs the daily transactions.
- Acting supervisor when reception coordinator is not present.
- Provided clerical support to 50 company employees by copying, faxing and filing documents.
- Collected and distributed messages to team members and managers to support open communication and high customer service.
- Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
- Answered inquiries and resolved or escalated issues to management personnel to ensure client satisfaction.
Rehab Office Coordinator, 07/2013 to 06/2015
Genesis Rehabilitation – Lake City , FL
Genesis Rehabilitation – Lake City , FL
- Supervised by Therapy Program manager, Brief PM on therapy caseload, resident and therapist schedules, all created in ROX.
- Tracking all therapy minutes in Rehab Optima, setting RUG levels, and going through projections to plan out minutes.
- Completed all technical audits of charts, ensuring all documents are present, monthly submitted to cooperate.
- Maintains all filing for therapy department, photocopying, faxing,.
- Responsible for all department scheduling, full time, part time, and per-diem staff.
- Ensures all therapist licenses are current and posted.
- Track all physician referrals, evaluations, orders, and signatures.
- Stocking and ordering all supplies.
- Attend morning meeting with Administration and nursing staff, keeping a log of daily minutes,briefing therapist on relevant changes, maintained a positive working relationships with all of the departments.
- Assist with survey compliance.
- Daily temp logs, sending out equipment for re- calibration, and in-servicing and orienting all staff and new hires.
- Made sure all therapist payroll(s) are accurate and submitted in a timely manner.
- Persistent in getting Insurance authorizations, ARD' s, Med B cuts, and Secondary Insurance.
Certified Nursing Assistant, 09/2008 to 06/2015
Wellstar Health System – Hiram , GA
Wellstar Health System – Hiram , GA
- Experienced in long and short term care, mental health, Neuro.
- And Orthopedics.
- Assist residents with ADL's.
- Assisting nursing with treatments, procedures, or other medical necessities.
- Responsible for charting on all residents ADL's electronically in PCC.
- Deliver patient care with sensitivity and ensure patient dignity.
- Accompanied residents on doctor's appointments, gathering all necessary items and documentsneeded.
- Upon Admission, obtain appropriate equipment such as walkers, canes, and wheeled chairs.
Education
Certification: CNA, 09/2008
Red Cross - City
Red Cross - City
Nursing Program: 2009
Holyoke Community College - City, State
Holyoke Community College - City, State
Early Childhood Special Education, 2007
Greenfield Community College - City, State
Greenfield Community College - City, State
High School: 05/2005
Hopkins Academy - City, State
Hopkins Academy - City, State
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Resume Overview
School Attended
- Red Cross
- Holyoke Community College
- Greenfield Community College
- Hopkins Academy
Job Titles Held:
- Medical Referral Specialist
- Lead Receptionist
- Rehab Office Coordinator
- Certified Nursing Assistant
Degrees
- Certification : CNA , 09/2008
Nursing Program : 2009
Early Childhood Special Education , 2007
High School : 05/2005
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