Nancy Salgado Email & Phone Number

Park Ridge, Illinois, United States

Park Ridge, Illinois, United States

Greater Chicago Area

• Experienced adjudicator able to review claims in timely manner in order to process claims accordingly
• Determine accurate payment based on policy and procedures and the appropriate fee schedule
• Identify claims with inaccurate data or claims that require review by the appropriate team members and route claims as needed
• Resolve claims that require adjustments and complete special projects
• Maintain productivity goals, quality standards, and aging timeframes
• Assist with training material by providing suggestions and feedback on new and updated DTPs for changes

Greater Chicago Area

• Examine and compare claims with insurance plan and authorizations to determine coverage
• Calculate reimbursement of benefits per the appropriate fee schedule
• Communicate system errors and HFS/CMS updates to upper management for review and update on Payer Compass
• Assist Claims Research Team with claims inquiries and disputes
• Communicate and follow up with providers to provide claim updates and resolutions
• Function as a resource for examiners and assist with training

Greater Chicago Area

• Process urgent referrals and assist with scheduling patients in outside facilities
• Obtain urgent prior authorizations for diagnostic testing, consultations, and surgeries
• Assist patients with Financial Assistance Application and medication Patient Assistance Applications
• Request and obtain diagnostic and consult reports from outside facilities as requested
• Receive incoming calls, respond to patient inquiries, and distribute messages
• Send, retrieve, and route faxes; Maintain clinical files according to need

Greater New York City Area

• Perform point of care testing as needed by patients
• Screen patients for depression, alcohol, drug abuse, and smoking
• Vital, room patients, and set up in clinic procedures; Assist providers as needed
• Perform controls for HGB, HGB AIC, Glucometer, urine dip strips, rapid strep kits, and rapid HIV kits as required by Joint Commission
• Perform accurate EKGs, collect urine and blood specimens, and administer vaccines
• Ensure rooms, lab, and clinical area are organized and stocked