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Title Authorization Specialist Access Rep
Target Location US-MI-Garden City
Email Available with paid plan
Phone Available with paid plan
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Candidate's Name
Garden City, MI Street Address   EMAIL AVAILABLE PHONE NUMBER AVAILABLEOffice AdministratorProfessional office administrator with over 30 years experience directing all aspects of office operations.Proven results in creating positive office environments through developing staff, improving procedures, and supporting customers.Strong communication and relationship building skills utilized to resolve customer service issues, train and mentor staff, and collaborate with leadership.Working knowledge of medical terminology, CMS Prior Authorizations and clinic procedures, including transcription and documentation in alignment with industry regulations.Strengths in strategic planning, process improvement, and data analysis.Professional ExperienceMetro Transport Group  Knoxville, TennesseeAccounting Department-Freight Billing Specialist, June 2022-November 2022 (Contract)Expedite and TruckloadSending invoices and account updates to clients.Kept an accurate record of client accounts and outstanding balances.Received, sort, and track incoming payments.Validate debit accounts to ensure the credibility of payments.Issued receipts for received payments.Provided regular, accurate reports of billing data.Sylectus and Alliance softwareE5 Workflow  Sydney, Australia,Prior Authorization Specialist, July 2020-November 2020Pre-Authorization requests to payors, Managed Care (CMS). Interacts with clients, insurance companies, patients, and sales representatives as necessary to request prior authorizations. Responsible for updating account activity, updating patient and claim information and demonstrating proficiencies with the billing system to ensure all functionalities are utilized for the most efficient processing of claims. Documents eligibility, benefit and authorization information in accordance with established guidelines.ContinuedCandidate's Name   Page 2Detroit Medical Center  Detroit, MIPatient Access Rep ll, September 2019 to July 2020Patient registration, verify current demographics, obtain referrals, insurance verification and pre-authorization approvals for CMS for Physical Medicine and Rehabilitation in the Fluoroscopy Suite. CPT, ICD-CM, HCPCS LEVEL ll coding for Radiology.Reliable Drug and Alcohol Inc. - Romulus, MICollector, April 2019 to August 2019NON DOT/DOT drug and alcohol tester. Notifying flight crew members of selective process and random drug and alcohol screening based on federal guidelines mandated by the FAA and Department of Transportation. Urinalysis testing for the five panel THC, PCP, COC, OP, AMP respectively. In addition to (BAC) from a breath sample provided by standardized breathalyzer testing.Audrey Bruell, MD, PC  Livonia, MIClinical Coordinator, May 2003 to December 2018Managed office operations for a busy dermatologist practice, including office opening and closing, patient documentation, policies, procedures, staffing schedules, and infection control. Pre-Authorization for surgical procedures in CMS, private insurance companies, Evicore and Availity portals. Scheduling patient appointments, and insurance verification. Gather and document patient medical history and physician summary/diagnosis. Assist physician with non-invasive and surgery procedures. Authorize prescription refills and relay information to pharmacy. Respond to patient questions and resolve customer services issues. Direct quality control and train staff on infection control techniques in compliance with MIOSHA regulations.Additional Relevant Experience:Landstar Logistics, INC  Northville, MIDirector of Customer Service, September 1996 to January 2001Oversaw shipping operations and customer relations for a national transportation service. Responded to customer inquiries, resolved issues, and communicated delivery changes/expectations to customers andSupervisors. Managed shipments to achieve on-time shipment promise to customers by categorizing cargo by receipt location and scheduling with appropriate carrier. Ensured precise placement on trucks through estimating weights, heights, and centers of balance. Hired and trained shipping employees. Identified process improvement opportunities. Maintained ISO 9000 and 9002 certifications for quality systems.Selected Contribution: Improved compliance with industry standards, resulting in increased validation of shipping deliveries by 30%.Advanced Dermatology  Plymouth, MIOffice Manager/Regional Manager, June 1989 to August 1996Directed office operations and supervised staff for a regional dermatology clinic. Executed tactical plans to achieve company objectives and monthly clinic goals. Collaborated with billing department and management to increase revenue through accurate patient documentation for billing. Facilitated staff meetings to celebrate accomplishments, communicate policy and procedure changes, and gather feedback. Selected Contribution:Increased employee loyalty and reduced turnover by implementing innovative employee engagement programs.EducationCertified Medical Office AssistantCareer Center, Livonia, MI 1981-1983Studies in Healthcare AdministrationOakland Community College, Royal Oak, MI 1984-1986Studies in Business Administration / AccountingSchoolcraft College, Livonia, MI 1990-1992EMR EMA Training & Development, Modernizing MedicineLivonia, MI 2017-2018Studies in Outpatient Medical CodingAAPC Outpatient Coding, Member 2020

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