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Click here or scroll down to respond to this candidate Candidate's Name , Authorization Specialist
Bayside, United States, PHONE NUMBER AVAILABLE, EMAIL AVAILABLE
PROFILE Earnest and proficient authorization specialist for 1.5 years of progressive experience. Communicates clearly and
effectively while operating with a firm sense of accountability.
Experienced 18+ years in wholesale field. Adept in organization and customer relations with store operations
background.
E M P L OY M E N T H I S TO RY
Nov 2022 Present Authorization Specialist , Northwell Health Great Neck, New York
I executed prior authorizations for Radiology, Cardiology, Gastroenterology, and Prescription. As well as Prolia
and Reclast. Full knowledge of insurance referrals submissions. I analyzed and prioritized my work to ensure
workflow productivity.
Prior authorization management.
Utilization of insurance portals, including Evicore, Availity, Evolent and Cover my meds.
Submitted and followed through prior authorizations to insurances via payer specific portals and vendors.
Ensured all pertinent medical documentation is accurate and is present prior to authorization submission.
Properly evaluated and verified benefits and eligibility.
Responded to correspondence from insurance companies to patients.
Confidently handled authorization denials and or appeals.
Communicated any authorization denials to providers.
Organized and reassessed work for an excellent turn-around time in order to ensure timely authorizations.
Secretarial duties.
I identified problems and presented them along with suggestions for 'finding the yes' for patients. I not only
provided service to patients in a transactional way, but aimed to create hospitality by implanting solutions
independently.
Oct 2022 Nov 2022 Assistant Manager, The Dollar Store Garden City, New York
POS system.
Fulfilled assistant managerial duties.
Created an agreeable environment for a positive buying experience from entering the establishment to
completion of purchase. Word of mouth is the best and free advertisement.
Listened to customer needs and identified weaknesses and strengths and presented suggestions.
Secured purchases with real time stocked floor to ensure essentials which are always in need are available
for customer's needs.
Retained product, service, and company policy knowledge to serve as a resource for both coworkers and
customers.
Dec 2017 Aug 2019 Assistant Manager, Trendy Wholesale, Trendy Wholesale Bergen, New Jersey
Lead team of 5 coworkers.
Resolved loss of revenue with dispatched personalized email catalogs to customers on biweekly basis, thus
managed to secure orders with 30% of the recipients, and increased revenue.
Identified weaknesses and implemented practices to improve productivity goals.
Ensured quality control and enhancement of services to a competitive standard.
Handled inventory data to made adjustments, evaluated, forecasted, and met demands in accordance to
upward trends.
May 2002 Dec 2017 Merchandising & Sales, Christy 55W. Corp. New York City, New York
Took charge of training and led a team of 6 full-time members on work instruction and procedures.
Supervised to facilitate seamless operations and reduced process lags.
Merchandising.
Preserved well-stocked and organized store floor with the latest to strengthen and drive sales revenue.
Layout designs.
Effectively controlled the release and overturn of merchandise and decreased overstock by 10%.
Planned and executed orders, shipping & project.
Produced long term customer relationships through providing a positive purchasing experience.
E D U C AT I O N
Bachelor of Arts in Sociology, SUNY - Stony Brook University Stony Brook, NY
Dec 2019 Present Certificates, THRIVE NYC Mental Health First Aid NYC
Mental Health First Aid for Adults.
Mental Health First Aid for Youth.
SKILLS Prior Authorizations Autonomy
Critical & Analytical Thinking Good Communication
Attention Management Client Relations
Problem Solving On stage and Off stage presence
Electronic Health Records Secretarial Duties
(EHR)
Organized
L A N G UAG E S English Native speaker Korean Highly proficient
REFERENCES Reference available upon request.
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