Ash

Professional Healthcare Operations Specialist with an extensive background supporting prior authorizations, insurance verification, scheduling, staffing coordination, patient access, and healthcare operations in behavioral health, oncology, and hospital settings. Experienced working in fast-paced remote environments while coordinating with clinical teams, managing payer communication, utilization tracking, EMR systems, and ensuring accurate documentation, timely approvals, and smooth patient and/or staff scheduling.

Insurance Authorizations Specialist (REMOTE) - Acorn Health, LLC - Coral Gables, FL

(2021-06)

• Executed remote job functions in patient records management, achieving 100% HIPAA compliance & reducing documentation review time 20%.
• Manage the end-to-end prior authorization process for ABA services, verifying insurance, submitting and tracking requests, and following up with commercial and Medicaid/CMH payors via payer portals, resulting in a faster approval cycle and fewer delayed services.
• Support revenue cycle operations by identifying discrepancies, reducing claim denials by 20%, and improving workflow efficiency.
• Verify eligibility and benefits for 200+ clients using CHAMPS and payer portals, reducing eligibility-related denials.
• Process 100+ authorization requests monthly, ensuring timely approvals and uninterrupted patient care.
• Track utilization against authorized units, ensuring accurate billing and adherence to compliance standards for 100+ patient accounts.
• Collaborated with clinical providers and care teams to obtain required clinical documentation and expedite approvals reducing approval time by 30%.
• Maintain accurate documentation in CentralReach, ensuring alignment between services, authorizations, and billing requirements improving communication for 15+ support coordinators/case managers & reducing processing errors by 20%.
• Communicate with 10+ payers weekly to resolve authorization and claim issues, achieving a 95% resolution rate for timely processing and reimbursement.

Clinical Staffing Coordinator (REMOTE) - Amita St Mary and Elizabeth Medical Center - Chicago, IL

(2020-01 - 2020-12)

• Allocated resources for NW, Chicago & Southern Regional Float Pools, reducing staffing gaps by 30% across 4 hospital units through scheduling.
• Strategized to deploy clinical personnel for 4a & 4p shifts in Chicago hospitals, boosting patient safety by 20% and associate satisfaction by 15%.
• Partnered with clinical leadership to fill 100% of staffing requests, improving patient care quality scores and boosting team efficiency by 25%.
• Communicated with 10+ float pool associates to optimize staffing & cut scheduling errors by 20%. Delivered timely shift cancellation updates, improving efficiency & boosting morale.
• Established Interdepartmental communication protocols among 20+ support staff, leading to a 15% boost in positive patient testimonials highlighting improved care coordination.
• Helped Kronos scheduling for 100+ clinical staff optimizing SharePoint data tracking, increasing schedule accuracy 20% & enabling faster decisions.
• Navigated the Workforce Timekeeper application to streamline time tracking processes for over 10+ employees, enhancing accuracy & saving the team valuable hours each week.

Bone Marrow/Stem Cell Assistant Transplant Coordinator/Medical Scheduler - Illinois Cancer Specialists - Niles, IL

(2015-06 - 2019-05)

• Partnered with the BMT team at Advocate Lutheran General Hospital, leading initiatives that improved patient care 20% & optimized team processes.
• Enhanced transplant procedures through in-depth research of Autologous & Allogeneic techniques, resulting in 15% improvement in patient outcomes.
• Updated & maintained LGH Transplant Program's patient-specific clinical forms, boosting compliance & reducing processing time by 20%, driving 15% increase in patient satisfaction.
• Coordinated all chemotherapy appointments in EMR at ICS, ensuring that over 100 patients enjoyed easy access to a clear and organized appointment calendar each month.
• Scheduled 50+ pre-diagnostic tests, improving patient wait times by 20%, while collaborating with specialists to enhance care coordination at LGH.
• Streamlined the management of transplant patient care by organizing 100+ patient binders and entering diagnostic test & lab orders into the EMR, enhancing documentation patient tracking.
• Prepared and labeled over 100 transplant test specimens, submitted them promptly to labs, which improved the accuracy of requisition processes
• Correlated timely admissions for 50+ transplant patients by partnering with LGH Admission teams, improving patient preparedness & satisfaction.
• Collaborated insurance documentation for 75+ patients accelerated approvals by maintaining clear communication with LGH transplant office, cutting wait times 3 days.
• Identified NMDP donor registry details for 30+ cases reducing match turnaround times 40% and expediting patient treatment plans.
• Compiled & submitted detailed data for FACT & CITRIC Audits, ensuring 100% compliance & contributing to a smooth audit process that strengthened organizational accountability.
• Provided LGH Transplant Program clinical updates for 200+ patients, integrating office notes and lab results using Microsoft Office 365 to support treatment strategies and improve patient outcomes by 15%.

Receptionist/PSR/Triage - Illinois Cancer Specialists - Niles, IL

(2013-10 - 2015-06)

• Led triage coordination for six physicians, improving emergency response times by 30% & enhancing patient care effectiveness.
• Supported 6 physicians & engaged 300+ patients by applying Hem/Onc terminology expertise, improving understanding & satisfaction.
• Collected, processed, & verified 200+ patient insurance records with 98%, minimizing claim rejections & cutting processing time by 25%.
• Optimized 20+ patient entries to streamline hospital billing & scheduling.
• Guided patients through lab order explanations and appointment scheduling, resulting in smoother experiences and higher patient satisfaction

Administrative Assistant - Achieve Orthopedic Institution Rehab - Schaumburg, IL

(2012-07 - 2013-10)

• Served as the call leader for the office, managing operations including opening and closing procedures, handling emergencies, and dispatching resources, which streamlined communication and improved service responsiveness.
• Boosted customer and patient satisfaction by managing over 100 new patient accounts, streamlined scheduling processes, and ensuring efficient insurance verifications, pre-authorizations, and compliance records.
• Verified insurance eligibility for an average of 30 patients weekly, ensuring timely pre-authorizations and enhancing overall patient satisfaction.
• Streamlined patient payment processes, increasing transactions 30% and ensuring compliance in reconciliations for financial audits.
• Executed ultrasounds on 3+ patients, improving diagnostic accuracy by 20% and elevating overall patient care.

Sales Associate/Assists Visual Manager - Carson Pirie Scott - Schaumburg & West Dundee, IL

(2011-05 - 2012-04)

Customer Service - Edible Arrangements - Bloomingdale, IL

(2009-01 - 2011-04)

Associate of Applied Science - Fashion Merchandising/Visual Merchandising & Marketing - College of DuPage (2008-08 - 2011-12)

Diploma - General Studies - Bartlett High School (2005-08 - 2008-06)