Business & Supply Systems Mgr Cardiac Cauterization - Prisma Health - Sumter, SC
(2025-05)
- Improved departmental supply management and inventory processes to support cost control, availability of critical supplies, and efficient daily operations.
- Conduct daily charge reviews and support accurate charge capture, billing workflows, and financial reconciliation.
- Monitor department statistics, operational metrics, and impact-board data to support leadership decision-making and performance improvement.
- Partner with Epic/IT analysts to identify system issues, improve workflows, and resolve electronic documentation and ordering concerns.
- Identify and address workflow gaps affecting Cardiac Rehabilitation referrals, scheduling, charge capture, and patient transitions.
- Maintain department readiness for regulatory and accreditation requirements, including ensuring policies, documentation, education materials, and operational processes remain current and compliant.
- Coordinate with vendors and internal departments regarding supplies, equipment, services, and staff education.
- Support process-improvement initiatives designed to increase efficiency, reduce errors, improve patient access, and enhance the overall patient experience.
- Collaborate across multidisciplinary teams to resolve operational challenges and ensure the department's daily business and clinical support needs are met.
Authorization and Referral Specialist,CHAa - Prisma Health - Sumter, SC
(2021-06)
Manage the referral, authorization, scheduling, and patient access processes for Cardiac and Pulmonary Rehabilitation programs. Coordinate closely with providers, insurance companies, patients, clinical staff, and hospital departments to ensure timely processing of referrals and authorizations and minimize barriers to care. Review patient records and orders for completeness, verify insurance benefits and eligibility, obtain required authorizations, and assist patients with financial assistance and medication-access resources.
- Streamlined referral and authorization workflows to improve timely access to Cardiac and Pulmonary Rehabilitation services.
- Coordinate high-volume referrals while ensuring documentation and payer requirements are met.
- Review clinical documentation and patient records to identify missing information and prevent delays in authorization and scheduling.
- Work directly with insurance companies and providers to resolve authorization issues and support successful patient enrollment.
- Assist patients with hospital financial assistance programs, medication assistance, and other community resources when financial barriers affect access to care.
- Collaborate with Vocational Rehabilitation representatives and other community partners to coordinate appropriate patient resources and referrals.
- Maintain accurate and up-to-date patient education materials and program documentation to support regulatory and accreditation requirements.
- Perform chart reviews and monitor Individualized Treatment Plans (ITPs) for completeness and compliance.
- Support Epic and MyChart workflows, including patient scheduling, referral management, and patient access needs.
- Contribute to quality-improvement initiatives that enhance referral accuracy, patient access, workflow efficiency, and continuity of care.
- Serve as a key liaison between patients, providers, payers, and rehabilitation staff to provide a seamless patient experience.
- Streamlined and updated all Cardiac and Pulmonary Rehabilitation patient education materials, including coordinating Spanish translations to improve accessibility.
- Developed PowerPoint presentations and digital educational content for classroom instruction using Smart TV technology.
- Improved consistency, accessibility, and engagement in patient education while supporting program standards and compliance.
