Natalie Grimes Email and Phone Number

Audit schedules to ensure patient verification, addressing coverage issues proactively.Obtain referrals and authorizations, enhancing payment accuracy and reducing delays. Achieving a daily quota of 100+ authorizations Serve as a reference for team, collaborating to resolve complex insurance challenges.Index incoming records efficiently, ensuring seamless referral processing.Meticulously review insurance policies, ensuring comprehensive understanding of coverage details. Maintain accurate records and documentation for seamless claim processing.

• Utilization of medical record systems to enter patient data and analyze financial bill payments and records.• Responsible for handling day-to-day operations relating to financial clearance activities.• Obtain insurance coverage benefits and authorization from third-party payers.• Manage worklists for cases requiring pre-authorization and work directly with the payor to obtain all required pre-authorizations.• Screening patients daily for financial assistance and assigning cases to specific team members as needed. • Develops and implements process improvements to streamline financial clearance activities and optimize efficiency.• Identify and address any issues or barriers that may prevent patients from receiving financial clearance, such as lack of insurance coverage or inability to pay.• Ensure accurate and timely communication of patient financial information to insurance companies and other payers.

• Verified insurance coverage and prior authorization benefits for patients daily with third-party payers and vendors.• Completed procedure prior authorizations for diagnostic imaging, neuropsychological testing, infusions, and prescribed medications using knowledge of ICD-10 and CPT codes.• Scheduled mail orders and deliveries for infusions and procedural injections.• Authorized workers’ compensation cases for consultations and in office testing on request by healthcare providers.• Coordinate with healthcare providers to gather necessary medical documentation for prior authorization requests.• Collaborate with insurance companies to ensure accurate and timely processing of prior authorization requests.• Review and analyze prior authorization denials to identify trends and patterns and recommend strategies to minimize denials and improve approval rates.

• Obtained medical records and referrals from primary care and pain management providers offices.• Verified insurance coverage for specialist benefits and submitting prior authorizations through third party vendors. • Managed office scheduling, email correspondence and high-volume phone calls patients. • Assist patients with filling out necessary paperwork, ensuring all information is complete and accurate.• Managed office finances, monthly bank deposits and collecting insurance payments.• Utilize electronic medical record systems to maintain and update patient information accurately and efficiently.• Provide exceptional customer service to patients, ensuring their needs are met and their questions are answered in a timely and professional manner.• Manage inventory of office supplies and order new supplies as needed to ensure the smooth operation of the medical office.• Coordinate with billing department to ensure accurate and timely submission of insurance claims and follow-up on any denials or discrepancies.