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Click here or scroll down to respond to this candidateCandidate's Name
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PHONE NUMBER AVAILABLE EMAIL AVAILABLEObjectiveTo build upon my abilities and knowledge with an employer that provides opportunities for growth and advancement in a medical or office context.Professional ExperiencesPrior Authorization Specialist, Myndshft Technologies 2022 Manage and document all correspondences and interactions with insurance companies and internal customers as needed Respond to requests for prior authorizations and ensure accuracy within company set standards Facilitate the coordination of Peer-to-Peer meetings between prescribing doctor and insurance authorization reviewer. Secure patients demographics and medical information by using discretion and ensuring that all procedures are in sync with HIPAA compliance and regulation Prior Authorization Coordinator, Optum Infusion Services/United Health Group 2017 - 2022 Respond to requests for prior authorizations and ensure accuracy within company set standards Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed Collaborate with other departments to assist in obtaining prior authorizations/appeals Manage and document all correspondences and interactions with insurance companies and internal customers as required Review insurance denials and submit appeals (as permitted by payor) Secure patients demographics and medical information by using discretion and ensuring that all procedures are in sync with HIPAA compliance and regulation Medical Records Retrieval Specialist, Humana Insurance 2016 2017 Obtained Records from Hospitals, Doctor's Offices & Clinics Utilized working knowledge of the correct documents needed to assemble a request packet Conducted research via telephone, internet and other reference materials to identify or confirm proper accounts for custodians of records Conducted follow-up calls with custodians to ensure requested records were collected in a time frame consistent with SLA parametersCustomer Quality Specialist, Apria Healthcare, Overland Park, KS 2011 2016 Verified insurance information and obtained clinical information needed for processing orders or reimbursement. Contacted patients to inform them of the order placed on their behalf and confirmed all patient demographic information, communicated any financial responsibilities and/or solicited additional information, and promoted other company product and services, as appropriate. Processed information received from intake/service personnel. Ensured proper selection of information online to ensure timely delivery and appropriate revenue recognition for order. Maintained appropriate documentation received with order and conducted follow-ups Demonstrated professional etiquette and courtesy when interfacing with customers. Resolved patient/customer complaints by identifying problems and coordinating appropriate corrective action.Patient Referral Coordinator, Care Centrix, Overland Park. KS 2009-2011 Coordinated services for patients prior to discharge i.e.: Medical Equipment, Skilled Nursing, and/or therapies.Admissions Clerk/Unit Secretary, Heartland Spine & Specialty Hospital, Overland Park, KS 2007-2009 Captured data such as demographic characteristics, history and extent of disease, diagnostic procedures, and treatment into computer.Unit Secretary, Select Specialty Hospital, Kansas City, MO 2005- 2006 Operated office equipment and applications such as messaging systems, Word, Excel and other software applications to prepare reports, invoices, financial statements, letters, case histories, and medical records.EducationResearch Medical Center, Kansas City, MO- Certification, Unit Secretary Training Course Kansas City Vocational/Technical School, Kansas City, MO- Certification, Medication Technician Tarkio College, Kansas City, MO- Certification, Nursing Assistant Course Pioneer Community College, Kansas City, MO Certificate, Computer Literacy Additional references are available upon requestCandidate's Name
15005 Grand Summit Trail Apt 203 Grandview, MO 64030PHONE NUMBER AVAILABLE EMAIL AVAILABLEReferences Kathy McAllister PHONE NUMBER AVAILABLE Josie Fulce PHONE NUMBER AVAILABLE Angela Bolton PHONE NUMBER AVAILABLE Emily Wadsworth PHONE NUMBER AVAILABLE Arlene Bailey PHONE NUMBER AVAILABLE/pre> |
