Experience

Urologic Specialists

• United States
• Medical Practices
• 1 - 100 Employee

• Medical Receptionist/Precertification

  • Jul 2019 - Present

  Contact patient insurance companies to obtain pre-certification of requested diagnostic testing, treatment and/or surgeries. Follow up with patients with determination. Document in computer system. Schedule, reschedule, and verify patient appointments. Check in and check out the patients ensuring accuracy of patient information as well as completeness of co-pays, charges, and insurance information. Contact patient insurance companies to obtain pre-certification of requested diagnostic testing, treatment and/or surgeries. Follow up with patients with determination. Document in computer system. Schedule, reschedule, and verify patient appointments. Check in and check out the patients ensuring accuracy of patient information as well as completeness of co-pays, charges, and insurance information.



Smart Healthcare Solutions

• Harrington Park, New Jersey

• Medical Billing Associate

  • Dec 2018 - Jul 2019



Stafford Communications

• Employee Records Specialist

  • Mar 2018 - Oct 2018

  Store, track and manage employee records, maintaining documents according to retention scheduling. Fulfill record retrieval requests, assisting with file mitigation and perform audits to ensure accuracy Store, track and manage employee records, maintaining documents according to retention scheduling. Fulfill record retrieval requests, assisting with file mitigation and perform audits to ensure accuracy



Centers Plan for Healthy Living

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Grievance and Appeal Specialist

  • May 2017 - Mar 2018

  Research clinical documentation to be provided to medical staff for review. Investigate member complaints. Prepare written documentation for Complaint and Appeal outcome. Research clinical documentation to be provided to medical staff for review. Investigate member complaints. Prepare written documentation for Complaint and Appeal outcome.



Beacon Health Options

• United States
• Mental Health Care
• 700 & Above Employee

• Clinical Appeal and Denials Coordinator

  • May 2015 - May 2017

  Research Medical Records to prepare clinical summaries for licensed clinicians to review for medical necessity. Schedule and facilitate in a live environment, the last stage if the internal appeal process. Provide Written Documentation to both the patient and provider once an appeal decision has been rendered Research Medical Records to prepare clinical summaries for licensed clinicians to review for medical necessity. Schedule and facilitate in a live environment, the last stage if the internal appeal process. Provide Written Documentation to both the patient and provider once an appeal decision has been rendered