Knowledgeable with solid foundation in patient access operations. Demonstrated ability to enhance patient satisfaction and streamline administrative processes. Proven track record in managing patient information and ensuring compliance with healthcare regulations.
Overview
19
19
years of professional experience
Work History
Patient Access Specialist
Springfield Clinic
12.2024 - Current
Coordinated with clinical staff to manage patient flow, reducing wait times and improving satisfaction.
Assembled registration paperwork and placed identification bands on patient.
Resolved issues related to registration process including eligibility verification and authorization problems.
Verified patients' insurance and payment methods during admissions or check-in processes.
Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
Maintained accurate records of patient registration information in electronic health record system.
Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
Verified patient insurance coverage, collected copays and other payments, processed credit card transactions.
Processed and evaluated authorization requests for accuracy and compliance with regulatory standards.
Collaborated with healthcare providers to resolve discrepancies in patient information and authorization details.
Led initiatives to optimize data management within electronic health record systems for improved access to authorizations.
Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
Process prior authorization requests to ensure compliance with insurance policies
Evaluate patient information for medical necessity and eligibility criteria
Coordinated prior authorization requests to ensure compliance with insurance policies and procedures.
Managed complex prior authorization cases, demonstrating strong problem-solving skills and attention to detail.
Specialized Foster Parent
Camelot Care Ctr
03.2007 - Current
Attended trainings and workshops on topics related to fostering such as trauma-informed care and attachment theory.
Utilized problem solving techniques when addressing challenging behaviors exhibited by the youth.
Supported the development of healthy life skills through positive reinforcement and guidance.
Cultivated meaningful relationships with foster children by providing emotional support during times of crisis or transition.
Fostered positive relationships with biological families, facilitating visits and communication where appropriate.
Encouraged positive social interactions and modeled respectful behavior to teach empathy and cooperation.
Patient Access Specialist
St Johns Hospital and Clinics
01.2023 - 12.2024
Assembled registration paperwork and placed identification bands on patient.
Resolved issues related to registration process including eligibility verification and authorization problems.
Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
Verified patients' insurance and payment methods during admissions or check-in processes.
Assisted with scheduling appointments, pre-registration activities, verifying demographics and insurance information.
Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
Reached out to insurance carriers to obtain prior authorization for testing and procedures.