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Skills

  • Cross-functional collaboration
  • Disease prevention and intervention specialist
  • Intravenous therapy
  • Strong presentation skills
  • Strong clinical judgment
  • Issue resolution
  • One-on-one Instruction
  • Patient data confidentiality
  • Staff Coaching
  • Tracheostomy care

Work Experiences

  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Customer service, patient scheduling, and billing were among the duties I coordinated in the front office.
  • Achieved a 51% reduction in unresolved claims.
  • Looked over insurance coverage for patients to see who was responsible for payment.
  • Achieved departmental goals by collaborating cross-functionally to address authorizations that exceeded one year.
  • Gathered and processed patient liability statements prior to service.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Prioritized unscheduled and emergency authorizations, routing them to the appropriate personnel for immediate action.
  • Was in charge of financial documents like expense reports and invoices.
  • Checked service providers' eligibility and compliance with authorization requirements.

Summaries

  • Surgical procedures, restocking supplies, and updating electronic health records are all things that she can help with.
  • Professionally trained Prior Authorization Specialist with experience providing high-quality culturally competent care to a diverse group of patients.
  • Dedicated to following the medical funding guidelines and policies that have been established.
  • Committed to providing comprehensive patient education as well as assisting physicians.
  • Proven leader with experience working in a team environment.
  • Clinical Nurse with extensive knowledge of quality assurance and the ability to create individualized care plans.
  • Registered Nurse with 13 years of experience in critical care.
  • Billing Supervisor with extensive experience in day-to-day accounts receivable operations, collections, and reporting.
  • Looking for a position as a leader in an integrated delivery system.
  • Committed to providing the best possible care for patients and their families.

Accomplishments

  • Educated
  • Observed
  • Consulted
  • Patient Care: Ensured quality control through admissions, assessment, treatment, and referral for a broad range of patients. Treated patients suffering from trauma, acute chest pain, respiratory failure, and drug overdoses.
  • Recognized
  • Provided
  • Patient Education: Educated patients in regards to office policies, medical procedure steps, recovery measures and medication instructions.
  • Oversaw
  • Physician Support: Consistently praised by physicians for efficient assistance in minor surgical procedures and patient processing handling.
  • Formulated

Affiliations

  • National Unified Claims Committee (NUCC) membership
  • American Association of Healthcare Administrative Management (AAHAM)
  • Project Management Institute (PMI) - Project Management Professional (PMP) (2020)
  • Educational Seminars by system
  • Sigma Theta Tau International (Nursing Honor Society)
  • Certification in Prior Authorization by method
  • International Association of Insurance Professionals (IAIP)
  • American Marketing Association
  • Chapter Leader for Austin Healthcare Administrative Professionals Network
  • National Association of Insurance Commissioners (NAIC)

Certifications

  • ANA Certified in Gerontological NP
  • Prehospital Trauma Life Support (PHTLS)
  • Certified Business Analysis Professional (CBAP)
  • Certified Electronic Health Records Specialist (CEHRS)
  • Certified Coding Specialist - Physician-based (CCS-P) by AHIMA
  • Salesforce
  • Certified Ambulatory Coder (CASC) by Ironclad Systems
  • ServSafe
  • Certified Health Data Analyst (CHDA) by AHIMA
  • Nitrous Oxide Administration Certification

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