Sunny Chatlani

Patient Access and Healthcare Coordinator with 10+ years of experience in patient scheduling, insurance verification, prior authorization, and HIPAA-compliant medical records management across health insurance, home health/hospice, and orthopedic care settings. Skilled in EHR/EMR documentation, cross-functional coordination with clinical and physician teams, and delivering high patient satisfaction in high-volume healthcare environments.

Senior Process Associate, Patient Access (Ocala ENT & Pulmonary) at Flatworld Healthcare Services (2026-02 – 2026-05)

• Coordinated and optimized complex multi-provider scheduling matrices for ENT physicians, audiologists, and Nurse Practitioners/Physician Assistants, scheduling diagnostic and clinical visits including audiograms, sleep studies, allergy testing, pulmonary function tests (PFTs), spirometry, nasal endoscopy, and CPAP titration appointments.
• Managed high-volume inbound and outbound patient communications, triaging urgent symptoms, routing medical inquiries, and capturing accurate demographic data during intake.
• Conducted insurance verification and benefits review, assessed managed care requirements, and secured prior authorizations for ENT and pulmonary procedures ahead of patient encounters.
• Educated patients on pre-visit protocols and diagnostic requirements, including pre-operative documentation packets and preparation instructions for allergy panels, sleep studies, and audiometric testing.
• Updated and maintained real-time Electronic Health Record (EHR) data, physician referral queues, and clinical workflow documentation.
• Supported front-desk operations during peak hours, including patient check-in, co-pay collection, and schedule reconciliation.

Senior RCM Executive at Redroad Healthcare Business Solutions (2025-05 – 2025-09)

• Screened incoming patient referrals from hospitals, nursing homes, and physician offices to determine eligibility for home care and hospice services.
• Verified insurance eligibility and benefits for Medicare, Medicaid, and private payers prior to care initiation.
• Entered and maintained accurate demographic and clinical information in Electronic Medical Records (EMR).
• Coordinated Start of Care scheduling with physicians to obtain required medical orders and documentation.
• Maintained HIPAA compliance and patient confidentiality across all interactions and data handling.

Senior Process Associate, Patient Access at Flatworld Healthcare Services (2024-11 – 2025-01)

• Managed scheduling, patient communications, and medical records for an orthopedic care provider network.
• Verified patient insurance coverage and resolved prior authorization requirements for orthopedic services.
• Coordinated urgent care referrals, prioritizing scheduling to minimize patient wait times and maximize physician availability.
• Supported patients in navigating the online patient portal for appointments, prescription refills, and secure messaging.
• Documented all patient interactions in the EHR system in compliance with healthcare regulations and organizational policy.

Senior Analyst, Billing (Inbound/Outbound) at Starmark (2024-01 – 2024-06)

• Managed inbound and outbound patient account communications regarding billing status and repayment plans.
• Set up payment plans and financial assistance options for self-pay patients.
• Monitored delinquent accounts and escalated high-risk cases in accordance with Accounts Receivable guidelines.

Senior Clinical Admin Coordinator at XLHealth Corporation (UnitedHealth Care) (2021-06 – 2022-09)

• Served as primary point of contact for providers and members regarding clinical services, benefits, and authorizations.
• Reviewed procedure codes against benefit coverage and notification requirements to determine next steps.
• Processed referral and prior authorization requests, coordinating with clinical teams to ensure timely responses.
• Documented call history and member data accurately across internal systems, supporting the intake and census process.

Provider Reimbursement Specialist at Logixhealth Solutions (2019-10 – 2021-01)

• Managed high-volume inbound calls from patients, attorneys, and insurance representatives regarding medical billing and claims.
• Reviewed and processed insurance claims to ensure accurate reimbursement for medical, auto, and worker's compensation cases.
• Resolved patient billing disputes and appealed claims for timely filing on behalf of patients.
• Coordinated PCP referrals and VA authorizations in accordance with client guidelines.

Claims Adjudication Specialist (Outbound/QA) at XLHealth Corporation (UnitedHealth Care) (2013-09 – 2017-11)

• Ensured HIPAA and patient confidentiality compliance while performing HEDIS government compliance record retrieval.
• Conducted provider and member outreach to verify medical records, claims data, and coordination of benefits.
• Updated clinical and enrollment data in electronic systems and scheduled annual wellness and house call visits.
• Processed Medicare and government forms, including CMS1500, UB04, and Medicare Claim Appeal forms.

Customer Support Executive (Inbound) at Aegis Ltd. (AOL Account) (2011-05 – 2013-07)

• Supported AOL dial-up and broadband subscribers with account, billing, and technical escalation queries.
• Assisted new hire batches with daily performance tracking and support call handling.
• Promoted to the billing and escalations team to handle complex member issues.

Pre-University Course (2nd PUC) – Amity Academy Junior College (2005)