Intake Coordinator/ Reimbursement Specialist - Gentiva - Sandy Springs, GA
(2017-01)
- Develop and strengthen client relationships, work with hospitals, clinics, facilities and the clinical team to handle request for services from members and/or providers
- Successfully manage the referral process, prepare incoming and outgoing referrals, and prior authorizations, including intake, review requests for adverse determination, approval/processing notification requirements
- Efficiently performs initial telephone screening to determine the patients appropriateness for home care
- Communicates authorization specifics to providers either verbally on phone calls or written through fax
- Successfully resolved client complaints and diffused negative situations through effective conflict management skills
- Developed solid partnerships with customers and managed in multiple client relationships
- Successfully renewed contracts for multi-year agreements resulting in increased contracted revenue
Intake Coordinator - Guardian Home Care - Marietta, GA
(2015-01 - 2017-12)
- Applied clinical knowledge and critical thinking to identify patients' needs according to diagnosis and physician's order
- Retrieved and processed referral referrals via fax, telephone, and web portals
- Entered referrals in Homecare Homebase computer application system
- Researched and identified primary payer sources and identified benefits
- Requested initial authorizations for patient visits
- Notified branch office(s) of patient copays and insurance changes
- Successfully identified at risk accounts and liaised with groups to better serve clients
- Retained existing accounts through ensuring client needs are met
- Delivered high level customer service and ensured outstanding work cohesion with fellow team members
Home Health, Hospice, and Case Management Intake Coordinator - Pruitt Health
(2011-01 - 2015-12)
- Process referrals received through multiple phone lines and web portals
- Assign patients to LPNs for preliminary assessment to determine healthcare needs
- Handle all additional duties assigned duties assigned by management
- Verify all primary and secondary insurance information for all incoming patients
- Analyze referral/admission data and prepare assigned reports
- Effectively manage time to complete daily activities
- Complete financial clearance for all referrals by determining eligibility along with collections activities for commercial, self-pay, and private insurance payers in relation to patient responsibility
- Revamped record keeping and database administration/ reporting to furnish support staff with more accurate data
- Increased office efficiency through implementing workflow and process improvements resulting in productivity growth
- Ensured confidentiality maintenance with sensitive information, documents, client records and personal matters
Medical Case Management Intake Coordinator - Intracorp - Norcross, GA
(2007-01 - 2010-12)
- Served as the liaison between the Insurance company/TPA and Intracorp for Case Mgt. services
- Enhanced daily operations by assisting Training Department Manager and company in utilization of old and new software
- Managed day-to-day logistics and communication with nurses and personnel staff
- Supported Intake Officer in the effective management and control of Intake Items, principally in the areas of planning, monitoring and control, and overall BoW management
Service Recovery Specialist - Instawares - Norcross, GA
(2005-01 - 2007-12)
- Comprehensively reviewed invoices (both paid and outstanding) and recorded them in system to ensure accuracy of information and to provide basis for future reference
- Increased paperless account sign ups and provided assistance to customers throughout transition to ensure invoices were sent via email and paid online
- Built awareness with clients to help them find ways to meet their financial obligations without getting further behind
- Prepared delinquent account reports for senior leaders
- Provided information to collection agencies when all other avenues have been pursued