Kimberly Harmon

Responsible for all aspects involved in obtaining complex authorizations for outpatient infused medication.

• Communication with clinical staff, providers, pharmacists, and insurance companies to relay updated specialty drug policies and appeals.
• Maintain time sensitive Referral work que.
• Manage high volume stat mailbox for oncology department for high cost treatments that require to be worked on with in 24 hours.
• Work with patient and drug manufacturers to obtain provided drug or secure foundation assistance for patients.
• Analyzed medical records and other documents to determine approval of requests for authorization.
• Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
• Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.

• Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
• Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
• Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
• Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
• Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.

• Scheduled for 30 plus providers of various specialties.
• Worked on projects to implement population health management.
• Educated patients on potential out of pocket cost offer payment options.
• Facilitated timely check-in by greeting visitors and establishing purpose of their visit.
• Routinely collaborated with department managers to correct problems and improve services.
• Ensured HIPAA compliance.
• Evaluated patient care needs, prioritized treatment, and maintained patient flow.
• Collected and validated patient demographics and insurance information.
• Collected and processed co-payments and out-of-pocket charges using Passport.