Patient Pre-Certification Associate
Current▪ Manage interdisciplinary coordinated care for four doctors and two residents, ensuring medications arrive on time while maintaining a 98% response rate from the specialty pharmacies.▪ Coordinate medical procedures with doctors, nurse practitioners, residents, and administrative staff, resulting in high patient satisfaction and increasing patient appointments by 80%.▪ Provide care in diverse health systems, ensuring safety and well-being while adhering to MedStar Health Spirit Values… Show more ▪ Manage interdisciplinary coordinated care for four doctors and two residents, ensuring medications arrive on time while maintaining a 98% response rate from the specialty pharmacies.▪ Coordinate medical procedures with doctors, nurse practitioners, residents, and administrative staff, resulting in high patient satisfaction and increasing patient appointments by 80%.▪ Provide care in diverse health systems, ensuring safety and well-being while adhering to MedStar Health Spirit Values, Service, Patient First, Integrity, Respect, Innovation, and Teamwork.▪ Update weekly patient-care status reports on medical procedures and appointments for medical doctors, nurse practitioners, physician assistants, and nursing staff, resulting in more effective patient scheduling.▪ Collaborate to provide staff cross-training and onboarding for Electronic Health Records (EHR), Revenue Cycle Management system, Scanner Software, and Fax Work Que, improving efficiency in supporting departmental goals for patient care.▪ Document patient Protected Health Information (PHI) in the EHR, ensuring accurate medical terminology and compliance with policies and regulations, including HIPAA.▪ Collaborate with Humana Military and VA Community Care to obtain pre-certification and authorization for medical treatments, maintain accurate and complete patient registration, on-site insurance verification, and resolve billing discrepancies and referral denials.▪ Support medical clinicians and the leadership team with problem-solving, effective teamwork, and meeting deadlines, including billing issues, patient scheduling coordination, appointment cycles, outside patient referrals, follow-up care, and cancelations. ▪ Took the initiative to develop and implement a cohesive, effective process to enhance positive cross-departmental communication by organizing priorities, simplifying procedures, and ensuring compliance with policies and regulations, improving overall patient care and satisfaction. Show less