Medical professional prepared for this role, bringing valuable experience in clinical and administrative functions. Known for reliable support in patient care and effective communication with healthcare teams. Strong focus on collaboration and adaptability to meet changing priorities. Proficient in patient interaction, medical record management, and office support tasks. Experienced with healthcare procedures and patient assistance. Utilizes strong organizational skills to maintain efficient office operations and support patient care. Knowledge of medical terminology and clinical protocols ensures smooth coordination and effective patient communication.
Work History
Precertification Specialist
20 Years 5 Months
Huntsville Hospital | 05.2006 - Current
Coordinated prior authorization requests for scheduled procedures, ensuring compliance with payer requirements.
Verified insurance benefits, eligibility, and referral requirements before patient services.
Interpreted clinical documentation to support medical necessity reviews and authorization submissions.
Communicated with physicians, payers, and patients to resolve precertification delays and missing information.
Documented authorization status accurately in electronic health records and scheduling systems.
Trained staff on precertification workflows, payer rules, and documentation standards.
Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
Minimized claim denials by accurately coding procedures according to CPT guidelines before submission for approval.
Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
Elevated patient satisfaction by offering compassionate guidance and support during the often-stressful precertification process.
Answered phone calls and messages for multiple-physician offices, medical facility, scheduling appointments, and handling patient inquiries.
Answered phone calls and messages for multiple-physician offices, medical facility, scheduling appointments, and handling patient inquiries.
Certified Health Unit Assistant
20 Years 5 Months
Huntsville Hospital | 05.2006 - Current
Experienced in providing prior authorization support, including obtaining and verifying insurance information
Excellent customer service skills and ability to interact with patients in a professional and friendly manner
Proven ability to prioritize tasks and meet deadlines
Excellent verbal and written communication skills
Knowledge of medical terminology and medical coding
Oversees all aspects of logistics for Outpatient Medical
Create weekly reports for senior leadership on shipments and issues
Endoscopy Tech
3 Years 3 Months
Crestwood Medical | 06.2023 - 09.2026
Provide clinical support to physicians and nursing teams, including sterilization of instruments
Maintained and sterilized endoscopy equipment and supplies according to established standards
Adhered to all safety and infection control guidelines to ensure patient safety in accordance with hospital standards
Managed scope transport, tracking, and storage to maintain equipment integrity and availability.
Inspected reusable devices for damage, documenting maintenance needs and reporting equipment issues promptly.
Trained new staff on endoscope reprocessing steps, safety practices, and daily workflow expectations.
Improved workflow coordination between procedure rooms, decontamination areas, and supply management.
Certified Nursing Assistant
2 Years
Colburn Nursing Home | 07.2003 - 07.2005
Deliver compassionate care to patients suffering from acute conditions and injuries and ensure patient comfort during bed rest and transport
Provide wound care and change dressings in alignment with hospital protocols to improve circulation and reduce risk of infection
Provided assistance to patients for activities of daily living in a long-term care facility, including grooming, nutrition, bathing, and toileting
Monitored patient condition, reported symptoms to registered nurses, and provided support during medical procedures by providing equipment and positioning patients
Supported needs of 20+ residents under long-term care.