Access Service Representative New York Presbyterian Brooklyn Methodist hospital
•Manage Call Center Operations by answering a high volume of inquiries and resolving patient concerns, maintaining a 98% prompt response rate for missed calls.
•Coordinate Surgery Scheduling and daily outpatient/inpatient appointments for invasive and noninvasive Cardiac procedures, optimizing clinical department efficiency.
•Perform Pre-Authorizations, determinations, appeals and precertification using accurate CPT, ICD-10 codes and clinicals to ensure seamless Healthcare Revenue Cycle transitions in a timely process.
•Maintain and monitor accurate records of authorization requests, approvals, appeals, and denials.
•Liaison between physicians and patients insurance coverage for peer to peers if needed.
•Stay informed on insurance policies such as UHC, Aetna, BCBS, etc., their regulations, and industry trends related to prior authorizations
•Communicate and collaborate with healthcare providers, Insurances and patients to gather necessary medical documentation and respond to inquiries regarding authorization status.
•Ensure meticulous Data Entry and patient registration by collecting pertinent insurance information, facilitating accurate Utilization Review processes and HIPAA Compliance
•Resolve logistics issues by arranging patient transportation across multiple facilities, maintaining high standards of Hospital Administration and patient care.
