| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateSUMMARYSKILLSEXPERIENCECandidate's Name
EMAIL AVAILABLE / C: PHONE NUMBER AVAILABLEAmarillo, TX 79109Talented Prior Authorization Representative with extensive knowledge of implementing strategies to secure authorizations for clinical procedures. Quick learning expert delivering continuous clinical quality improvement. Superb influencing skills to communicate with credibility, tact and diplomacy. Detail-oriented with experience managing medical documents meticulously. Known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Offering the ability to multitask expertly in fast-paced environments.Precertification requirements and authorizationsEffective communicationMedical and dental claimsKnowledgeable in Quickbooks and Open DentalSoftwareDocument preparationFirst Aid/CPR certifiedOrganizationTeam managementInsurance billingPlanning and coordinationAccount managementInsurance information oversightPrior Authorization Specialist / Domain Surgical Inc. - Amarillo, TX 05/2019 - 07/2020 Compiled physical and digital paperwork to meet business and patient needs, including charts, reports and correspondence.Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.Entered patient information including insurance, demographic and health history into the system to keep all records up-to-date.Demonstrated proficiencies in telephone, e-mail, fax and front-desk reception within a high-volume environment. Educated patients on treatment procedures and post-procedure home care. Scheduled cleanings and dental appointments for patients using Open Dental software. Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients. Performed detailed medical reviews of prior authorization request, following established criteria and protocols. Applied knowledge of Medicaid and third-party payer requirements. Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills. Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions. Created master spreadsheet to record procedures, denials and approvals. Teacher's Aide Volunteer / First United Methodist Church - Dumas, Texas 04/2015 - 04/2016 Assisted the teacher with Bible activities and lessons and helped supervise children during snack time and organize activities for play break.EDUCATION AND TRAININGPrepared lesson materials and visual aids to reinforce lesson concepts. Contributed to positive, educational setting by delivering gentle discipline and promoting student success. Cleaned and organized classrooms, materials and supplies to support maximum efficiency. Family Nanny / Nanny/babysitter Jasmin Tarango - Dumas, Texas 10/2014 - 04/2016 Planned fun excursions to enhance physical abilities and expose children to stimulating, educational activities. Helped children complete homework and special assignments daily to support academic performance. Engaged with children, providing nurturing, safe environments to promote emotional, social and intellectual growth.Coordinated after-school activities and transportation for 3 children for practices and events. Followed routines to foster stability and structure in children's lives while parents were away. Retail Associate / Itsy Bitzy Bling - Dumas, TX 11/2011 - 05/2012 Promoted brand through event marketing, demonstrations and sales. Fostered customer retention by assessing and meeting product needs. Maintained assigned area to store standards by setting up and monitoring accurate ad signage and correct merchandise placement.Processed payments and maintained accurate drawers to meet financial targets. Maintained friendly, outgoing personality to promote positive work environment and build customer loyalty. Cashier / Braums Ice Cream - Dumas, TX 10/2009 - 01/2010 Performed customer service and custodial duties.Organized and maintained both physical and digital payment documentation for accurate filing and compliant recordkeeping.Received payments for food purchases and issued receipts.. Dumas High School - Dumas, TX 05/2012High School DiplomaAmarillo College - Amarillo, TXSome College (No Degree): EducationTexas Tech University - Lubbock, TXSome College (No Degree): Human Development And Family Studies Completed 55 college hours |
