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Skills

  • Regulatory compliance
  • Business operations
  • Lead generation
  • Problem resolution
  • Supervision
  • Compliance with framework standards
  • Budgets
  • Database management software
  • Conflict resolution
  • Project organization

Work Experiences

  • Conducted patient interviews for referral verifications, ensuring that all eligibility requirements were met before submission to providers.
  • Collaborated with insurance companies.
  • Collaborated with insurance companies to resolve claim denials related to invalid referrals, recovering over $7 in lost revenue.
  • Audited referral statuses.
  • Used Microsoft Excel to document referrals and results by entering metric data.
  • Based referrals on patient needs.
  • Followed up with clients and category specialists to get their feedback and gather reports.
  • Collaborated with Referral Management Clerk to secure prior approval for initiative procedures.
  • Achieved a compliance rate of 25%.
  • Clients were notified and reminded of their appointments.

Summaries

  • Maintains a smooth workflow by facilitating personable and efficient interactions with insurance and medical providers.
  • Costs were consistently reduced while profits were increased.
  • Referral Management Clerk is a multi-talented Referral Management Clerk who is consistently rewarded for planning and operational improvements.
  • Working with insurance companies and other medical professionals to obtain prior authorization and schedule important client appointments has proven to be successful.
  • Exceptional attention to detail, collaboration, and typing skills.
  • Ability to manage complex healthcare referrals while maintaining a record of 84% first-approval accuracy.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Dedicated to streamlining organizational procedures in order to improve office environments.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the metric business.
  • Achieved a 18% improvement in patient satisfaction.

Accomplishments

  • Collaborated with operations to automate referral data entry, reducing administrative workload by 28%.
  • Provided comprehensive follow-up for 16 patients weekly, ensuring that referrals were processed and appointments scheduled within three years.
  • Utilized the Asana platform for seamless integration of referral data with insurance verification systems, eliminating duplicate entry errors.
  • Resolved 3 patient case escalations over referral processing delays, restoring service timelines and patient satisfaction.
  • Trained 16 staff members in referral system usage, increasing overall department efficiency and decreasing approval time by 39%
  • Resolved product issue through consumer testing.
  • Designed new scheduling procedures for referrals, achieving a 2% rise in scheduled patient appointments.
  • Collaborated with team of 15 in the development of method.
  • Efficiently handled 12 active referral cases while providing weekly status updates across care teams for seamless communication.
  • Initiated a process review that uncovered bottlenecks in referral routing, reducing processing times by 80%.

Affiliations

  • Office and Professional Employees International Union (OPEIU)
  • American Health Information Management Association (AHIMA)
  • American Society of Safety Professionals
  • Association for Computing Machinery
  • Referral Systems and Authorization Specialists Group (RSAS)
  • Rotary International
  • Lions Club
  • American Society for Healthcare Risk Management (ASHRM)
  • Certified Medical Office Manager (CMOM) Program
  • American Marketing Association

Certifications

  • Certified Medical Office Manager (CMOM) - Summit Group
  • Certified Public Accountant
  • Apple Certified Associate (ACA)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Physician Practice Manager (CPPM) - Northwind
  • Certified Business Analysis Professional (CBAP)
  • Certified Public Accountant (CPA)
  • Health Insurance Portability and Accountability Act (HIPAA) Certification - Northwind
  • ServSafe
  • Certified Health Unit Coordinator (CHUC) - Brightline

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