Denise Gunn
New Bedford
Summary
Experienced healthcare coordinator skilled in EHR management and client engagement. Delivered effective communication between clients and providers, enhancing service delivery and client satisfaction. As a Recovery Support Navigator, facilitated client education and appointment scheduling, ensuring timely access to essential health services. Strong problem-solving skills contributed to improved healthcare coordination and prior authorization processes.
Overview
3
3
years of professional experience
Work History
Recovery Support Navigator/Prior Authorization Specialist
We Care Health and Wellness Center
Fall River
10.2024 - Current
- Assisted clients in navigating health services and wellness programs.
- Coordinated appointment scheduling with healthcare providers and community resources to enhance client access to services.
- Provided information on health initiatives and available support services.
- Collaborated with team members to enhance client service delivery processes.
- Maintained accurate records of client interactions and service referrals.
- Educated clients on community resources for housing, employment, health care, and legal aid to empower informed decision-making.
- Actively listened to clients in order to identify their needs and provide effective solutions.
- Connected clients with local organizations that can provide additional assistance or specialized services if necessary.
- Coordinated client referrals to community agencies or organizations.
- Counseled individuals on job search strategies including resume writing tips and interviewing skills preparation.
- Utilized electronic health record systems to track authorization status.
- Communicated with insurance companies to clarify coverage and eligibility issues.
- Maintained accurate records of prior authorization activities and correspondence to ensure compliance and facilitate efficient processing.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
TMS Coordinator/Authorization Specialist
Concierge TMS
New Bedford
05.2023 - 10.2024
- Processed patient authorization requests to secure timely approvals for necessary treatments.
- Reviewed authorization requests for accuracy and completeness.
- Monitored authorization timelines to ensure timely approvals for patients.
- Coordinated communication among providers, patients, payers, and departments to streamline authorization processes.
- Coordinated with clinical staff to gather necessary information for authorizations.
- Reviewed patient documentation for compliance with authorization requirements.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Supported billing processes by verifying insurance information and patient data.
- Maintained effective communication with healthcare providers and insurance companies.
- Utilized electronic health record systems for tracking authorization status updates.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Managed electronic health records to ensure accuracy and compliance with regulations.
- Facilitated communication between medical staff and patients effectively.
- Ensured compliance with health regulations and internal policies consistently.
- Coordinated scheduling for patient appointments and follow-up visits.
- Created spreadsheets utilizing Microsoft Excel for tracking authorization status updates from payers.
Education
CADC, LADC - Addiction Counseling
Bristol Community College
Fall River, MA06-2020
GED -
Bristol Community College
Fall River, MA09-1982
Skills
- EHR management
- Prior authorization
- Client education
- Appointment scheduling
- Insurance verification
- Healthcare coordination
- Records management
- Patient engagement
- Effective communication
- Attention to detail
- Time management
- Active listening
- Problem solving
- Team collaboration
Timeline
Recovery Support Navigator/Prior Authorization Specialist
We Care Health and Wellness Center
10.2024 - Current
TMS Coordinator/Authorization Specialist
Concierge TMS
05.2023 - 10.2024
CADC, LADC - Addiction Counseling
Bristol Community College
GED -
Bristol Community College