Meet Vicky Fox, Precertification Manager at Hattiesburg Clinic
From Louisiana to California, to Arizona and Mississippi, Victoria “Vicky” Fox, the precertification manager at Hattiesburg Clinic, has worked in the health care industry for 32 years and counting.
Born in Slidell, La., Fox began her health care career in Sacramento, Calif., where she lived for nine years, working in business operations and insurance management at a multi-system hospital.
“I was born in Slidell, but I spent most of my childhood in Luling, Louisiana, a small area in St. Charles Parish,” Fox said. “Shortly after I married my husband, Roger, we packed our bags and headed west. Going from small-town living to the west coast was a change of pace, but I enjoyed our time in California.”
“We lived an hour and a half from San Francisco, so we would spend the day on the pier, shopping and eating lunch or dinner in Fisherman’s Wharf, where you can find the best clam chowder.”
After spending almost a decade in northern California, Fox and her husband moved to Phoenix, Ariz., where she gave birth to her son, Dalton. The family of three resided in the Copper State for five years, where she continued to work in business operations and insurance claims management.
“It was a multi-system hospital, so they had hospitals in California, Nevada and Arizona,” Fox said. “The company consolidated its’ business offices, so I transferred to become part of their consolidated team in Phoenix.”
Then in 2003, Fox and her family moved back to the south to Hattiesburg, Miss., where she and her husband of 32 years discovered a new pastime.
“In our spare time, we compete in powerlifting competitions,” Fox said. “One day, I saw people training in the gym, and I thought it looked like fun. The next thing I know, I’m training for a competition.”
Powerlifting competitions consist of squatting, bench press and deadlifts, which as of last year, Fox was able to deadlift 308 pounds. Her next competition is in August.
“It’s all about having fun and doing better than you did the last time,” Fox said. “When we’re not competing, we also judge competitions for the United States Powerlifting Association (USPA).”
The two also compete in the highland games, a Scottish tradition that consists of stone put, caber toss, hammer throw and weight throw.
Outside of her heavy-lifting activities, Fox works as the precertification department manager at Hattiesburg Clinic. She started at Hattiesburg Clinic six years ago, working primarily in insurance denial management before she was promoted to precertification manager in March.
“It is our responsibility to ensure that the procedure being performed meets medical policy and to obtain precertification/authorization by the insurance company if needed,” Fox said. “We also review denials where the insurance comes back and decides that it didn’t follow or meet medical policy. Our employees will analyze the policy and work with the insurance company and department to try to get it overturned if applicable.
There are 17 employees in the precertification department. Fifteen of those are responsible for the precertification/authorizations and corroborate with department managers, nurses and the insurance company to obtain those authorizations. Additionally, one employee works with insurance denials for medical necessity and one performs denial analysis and reporting.
Each quarter, Fox reviews insurance denials and compiles a root cause analysis to discuss with the department managers. They address the denials and find ways to reduce them – whether through the system or education – to ensure denials are trending downwards.
“I like to research and problem-solve. I like the ability to work with different people in different departments across the clinic,” Fox said.
“We are behind the scenes in patient care, but we do play an important role in caring for our patients. We are able to make a difference by ensuring processes run smoothly so the patient can get the care that they need.”
If you could learn to do anything, what would it be? I would love to learn how to create resin art. I have a friend who does it, and I even watch videos of other artists and their processes. It’s mesmerizing.
Words that best describe yourself: Kind, dependable, loyal, analytical
If you had to eat one meal every day for the rest of your life, what would it be? Pepperoni and mushroom pizza. I don’t get to eat pizza very often, especially when we’re training for a powerlifting competition.
Favorite quote or verse? “I can do all things through Christ who strengthens me.” – Phillipians 4:13
On the hard days, I recall this verse and remember to lean back on my faith and know that I’ll get through it.
For more information on patient care, visit https://www.hattiesburgclinic.com/patients-visitors/.