Experience

2nd.MD

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Sr. Analyst, Local Support

  • Jan 2021 - Present

  Receive requests for member assistance regarding local provider recommendations or community resources Investigation of requests to identify additional information needed, or additional resources that could/should be offered Research of local providers or resources to evaluate: Insurance network coverage, quality measures, geographic alignment, and alignment with other stated member needs such as language, gender, and availability. Collection and dissemination of pertinent medical records (as needed) to support continuity of care. Facilitation of scheduling through sharing of collected information to involved parties, and/or direct assistance with initial appointment scheduling. Member follow up post recommendation to evaluate member satisfaction, resolution of request, and identification of additional support/resources needed. Additional duties as assigned I.e. cross coverage between departments with transferable skills sets



CHI

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Referral Specialist

  • Jul 2017 - Dec 2020

  Duties: Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers. Heavy use of Medical terminology, reading Physician orders. Assist Practice Manager with complaint resolution and solutions related to patient referrals. Knowledge with I -Exchange, Evicore, AIM, Availity, Tricare and all Medicaid and Market plan insurances. Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc. Perform other duties as assigned by the practice manager or physician. Daily huddles to discuss productivity with my team about New Referrals/WQ and Gen Mailbox Numbers.



Conifer Health Solutions

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Admissions Specialist/Rep PA II

  • Aug 2015 - Jul 2017

  Duties: Scheduling all major testing for the hospital such as MRI, CAT scan, Nuclear Medicine, Ultrasounds, and all radiology. Provide exceptional and professional customer service to patients, interact effectively with physicians, patients, residents, visitors, staff and the healthcare community, register Emergency Room patients efficiently and accurately, input insurance, identification cards and demographic information in Epic System, telephone coverage, outpatient scheduling Thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.).



Lowe's Companies, Inc.

• United States
• Retail
• 700 & Above Employee

• CSA

  • Feb 2005 - Dec 2015

  Duties: Scheduling all major testing for the hospital such as MRI, CAT scan, Nuclear Medicine, Ultrasounds, and all radiology. Provide exceptional and professional customer service to patients, interact effectively with physicians, patients, residents, visitors, staff and the healthcare community, register Emergency Room patients efficiently and accurately, input insurance, identification cards and demographic information in Epic System, telephone coverage, outpatient scheduling Thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.).