Acorn Health, LLC
Insurance Authorizations Specialist (REMOTE)
Coral Gables, FL · Jun 2021 -
- 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 to prevent over/under billing and maintain compliance.
- Collaborated with clinical providers and care teams to obtain required clinical documentation and expedite approvals reducing approval time by 30%.
- Maintain accurate documentation in Central-Reach, ensuring alignment between services, authorizations, and billing requirements improving communication for 15+ support coordinators/case managers & reducing processing errors by 20%.
- Communicate with payers to resolve authorization and claim issues, ensuring timely processing and reimbursement.
Amita St Mary and Elizabeth Medical Center
Clinical Staffing Coordinator (REMOTE)
Chicago, IL · Jan 2020 - Dec 2020
- 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.
Illinois Cancer Specialists
Bone Marrow/Stem Cell Assistant Transplant Coordinator/Medical Scheduler
Niles, IL · Jun 2015 - May 2019
- 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
Niles, IL · Oct 2013 - Jun 2015
- 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.
Achieve Orthopedic Institution Rehab Administrative Assistant
Schaumburg, IL · Jul 2012 - Oct 2013
- 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.
