Tiaisa stanley
White Plains,NY
Summary
Experienced in prior authorization within healthcare settings, handling tasks such as ensuring accuracy of patient insurance information and obtaining necessary approvals for medical procedures. Demonstrates strong skills in administrative work, documentation management, and fostering effective communication between patients, providers, and insurance companies. Known for problem-solving capabilities, precision in task completion and ability to positively impact workflow efficiency.
Overview
12
12
years of professional experience
Work History
Assistant Manger
Amalgamated Life Insurance Co.
01.2019 - Current
- Answer emails and inquiries for short term and long-term disability and Paid family Claim solutions for Statewide school district health insurance questions
- Manages insurance company inquiries, resolves service problems, documents customer requests, and finalizes policy adjustments
- Investigate and determine outcome of disability claims with sound and impartial judgment
- Answer telephone, route callers, take messages, and provide routine information to callers professionally and efficiently.
- Established processes for monitoring customer satisfaction levels.
- Monitored employee attendance records, timekeeping, and payroll information.
Administrative Assistant for Allergy department
ENT and Allergy Associates
01.2017 - 01.2019
- Verify insurance coverage and update any changes in the billing system
- Confirm provider's participation status with patient's insurance plan/network.
- Determine payer referral and authorization requirements for professional services.
- Contacted patients and PCPs to obtain necessary referrals for scheduled services.
- Initiate authorization and submit clinical documentation as requested.
- Follow through on pre-certifications until final approval is obtained.
- Manage faxes, emails, and phone calls.
- Communicate with surgical coordinators regarding authorization status or denials.
- Submit appeals in the event of denial of prior authorizations or denial of payment.
- Facilitated communication between different departments within the organization.
Behavioral Specialist
Hawthorne foundation
01.2013 - 01.2015
- Assessment, thorough intake evaluation of each client's mental and physical state, and their needs upon presenting for treatment.
- Executing the treatment plan is usually a collaborative effort between myself, the client, and other healthcare providers.
- Depending on the client's specific needs, these may include their psychiatrist, primary care physician, and dentist.
- Behavioral specialists are also responsible for educating the client's family, if necessary, including them in the treatment plan, and helping them understand their loved one's condition.
Education
AA liberal arts -
Westchester Community college
12.2019
Skills
- Medical Terminology
- Insurance Verification & Epic
- Prior Authorization
- Scheduling appointment
- Patient Registration
- Product and service knowledge
- Attention to Detail
- Electronic authorization processing
- Documentation and Correspondence
- Customer Relationship Management
Timeline
Assistant Manger
Amalgamated Life Insurance Co.
01.2019 - Current
Administrative Assistant for Allergy department
ENT and Allergy Associates
01.2017 - 01.2019
Behavioral Specialist
Hawthorne foundation
01.2013 - 01.2015
AA liberal arts -
Westchester Community college