Alegre Smith
Peoria,USA
Summary
Talented Prior Authorization Representative with years of implementing strategies to secure authorizations for clinical procedures. Expert delivering continuous clinical quality improvement. Superb influencing skills to communicate with credibility, tact and diplomacy.
Overview
1
1
Certification
5
5
years of post-secondary education
15
15
years of professional experience
Work History
Prior Authorization Representative
CVS Health
Scottsdale, AZ
12.2019 - 07.2026
- Coordinated with insurance companies to secure timely authorization for medical services, procedures, and medications.
- Communicated with healthcare providers, insurance companies, and patients regarding authorization status.
- Identified and resolved missing documentation by reaching out to providers, facilitating faster approval processes.
- Clarified authorization requirements and outlined next steps to patients and healthcare staff to ensure understanding and compliance.
- Reviewed patient and insurance information for accuracy and completeness.
- Processed prior authorization requests and verified required information and documentation.
- Submitted authorization requests through insurance portals, fax, phone, and electronic systems.
- Followed up on pending, approved, or denied authorization requests.
- Documented authorization information, reference numbers, and communications accurately in patient records.
Customer Service Representative
Adecco
Phoenix, AZ
11.2018 - 05.2019
- Answered high-volume inbound calls from clients and potential clients.
- Handled difficult or upset callers while providing professional customer service.
- Assessed legal inquiries and guided callers to appropriate departments for resolution.
- Gathered and documented client information accurately and confidentially.
- Identified the nature of legal inquiries and directed callers to the appropriate department.
- Provided general information about services and explained the next steps in the intake process.
- Demonstrated professionalism and empathy in addressing clients' sensitive concerns.
- Followed up with clients regarding appointments, documents, and case-related information.
- Managed difficult or upset callers by delivering professional customer service.
Security Officer
Allied Universal Security Services, Systems and Solutions
Dallas, TX
06.2018 - 10.2018
- Secured property by monitoring for theft, vandalism, and unauthorized access, enhancing overall safety.
- Monitored security cameras and reported suspicious activity.
- Inspected employees, visitors, and deliveries entering and leaving property, ensuring compliance with access protocols.
- Conducted regular patrols of the facility and surrounding areas.
- Ensured proper access control by checking identification of all individuals and deliveries entering and exiting the property.
- Verified identification and maintained access-control procedures.
- Documented incidents and completed daily activity reports to provide accurate records of security operations.
Pharmacy Technician Trainee
CVS Health
DeSoto, TX
01.2017 - 11.2017
- Assisted pharmacists in preparing and dispensing medications to patients.
- Contributed to team efficiency by assisting with multiple assignments.
- Filled prescriptions and processed insurance claims under supervision of pharmacist.
- Maintained inventory levels of pharmaceutical supplies and medications.
- Assisted with various tasks as requested by the team.
Customer Service Manager
Walmart
Cedar Hill, TX
08.2015 - 02.2017
- Supervised customer service associates and managed daily front-end operations to ensure smooth service delivery.
- Trained and coached employees on customer service policies and procedures.
- Resolved customer concerns professionally and efficiently.
- Trained and coached employees on customer service policies and procedures, enhancing team knowledge and compliance.
- Managed cashier coverage, breaks, and daily work assignments.
- Monitored checkout lines and worked to reduce customer wait times.
- Monitored checkout lines to streamline operations and decrease customer wait times.
- Ensured company policies, safety procedures, and customer service standards were followed.
Team Member
Labor Ready
Crest Hill, IL
01.2015 - 06.2015
- Executed data entry tasks for AGS, ensuring accuracy and organization of information, Managed inventory levels to ensure adequate supply for operations., Provided logistical support to drivers for safe and efficient transportation. CDL driver with necessary supplies and logistics for safe transportation. Assisted Supplied drivers with essential logistics support for operations.
- Executed data entry tasks for AGS, ensuring accuracy and organization of information., inventory, Assisted CDL driver with necessary supplies and logistics for safe transportation. with what they need.
- Prepared job sites for labor assignments.
- Operated tools and equipment safely to complete assigned tasks.
- Performed sterilization of hospital rooms to maintain health and safety standards.
Package Handler
FedEx Ground
Hutchins, TX
08.2011 - 12.2014
- Handled packages safely and efficiently to prevent damage.
- Prepared shipments for delivery and ensured packages were properly organized.
- Checked packages for labels, addresses, and shipping information.
- Verified labels, addresses, and shipping information to minimize errors in package delivery.
- Operated material-handling equipment and followed workplace safety procedures.
- Worked efficiently in a fast-paced environment while meeting productivity goals.
- Communicated with team members and supervisors to resolve package and shipping issues.
CNA/ Dietary Aid/ administration assistant
The Villa at Mountain View
Dallas, TX
05.2014 - 11.2014
- Assisted residents with daily living activities, such as bathing and dressing, to ensure their comfort and well-being.
- Reported and documented changes in residents' conditions to ensure timely care adjustments.
- Assisted cook in meal preparation for residents, ensuring nutritious and appetizing food options.
CNA
JK Home Health Service
Mesquite, TX
08.2013 - 10.2014
- Assessed individual needs of patients in their homes, delivering tailored support to enhance well-being.
- Supported patients with diverse health issues and special needs in clinical setting, fostering a compassionate care environment.
- Monitored vital signs and reported changes to nursing staff promptly.
- Provided emotional support and companionship to patients and families.
- Provided emotional support and companionship to patients and families, strengthening relationships and improving overall patient experience.
Cashier/Customer Service
Walmart
Grand Prairie, TX
03.2014 - 06.2014
- Operated cash registers and processed cash, credit, debit, and other payments accurately.
- Delivered friendly and professional customer service, enhancing customer satisfaction.
- Greeted customers and assisted them with questions about products and services.
- Handled cash, counted change, and maintained an accurate cash drawer.
- Managed cash transactions, ensuring accuracy in counting change and maintaining cash drawer balance.
- Processed returns, exchanges, and refunds according to company policies.
- Maintained a clean and organized checkout area.
- Assisted with bagging, stocking, and maintaining merchandise displays.
- Addressed customer concerns effectively, escalating complex issues to management for resolution.
Education
Upper secondary education - Instructor Program
Studio Academy of Beauty
Tolleson, AZ 10.2025 - 03.2026
Upper secondary education -
Studio Academy of Beauty
Tolleson, AZ 07.2022 - 07.2023
Upper secondary education -
Studio Academy of Beauty
Tolleson, AZ 02.2022 - 07.2022
High School Diploma -
Joliet West Township High School
Joliet, IL 08.2006 - 05.2009
Skills
- Health insurance verification
- Insurance authorizations
- EMR/EHR
- Medical office experience
- Data integrity and documentation
- Medical chart preparation
- Medication management
- Data entry
- Multi-line phone systems
- Call management
- Microsoft Outlook
- Microsoft Excel
- Time management
- Multitasking
- Telephone skills
- Customer Service
- Interpersonal communication
- Clear communication
- Attention to detail
- Organizational skills
- Teamwork
- Follows instructions
- Insurance authorizations
Additional Information
Authorized to work in the US for any employer
Certification
- Cosmetology Instructor License
- Cosmetology License
- Aesthetician License (Arizona)
Languages
English
Timeline
Upper secondary education - Instructor Program
Studio Academy of Beauty
10.2025 - 03.2026
Upper secondary education -
Studio Academy of Beauty
07.2022 - 07.2023
Upper secondary education -
Studio Academy of Beauty
02.2022 - 07.2022
Prior Authorization Representative
CVS Health
12.2019 - 07.2026
Customer Service Representative
Adecco
11.2018 - 05.2019
Security Officer
Allied Universal Security Services, Systems and Solutions
06.2018 - 10.2018
Pharmacy Technician Trainee
CVS Health
01.2017 - 11.2017
Customer Service Manager
Walmart
08.2015 - 02.2017
Team Member
Labor Ready
01.2015 - 06.2015
CNA/ Dietary Aid/ administration assistant
The Villa at Mountain View
05.2014 - 11.2014
Cashier/Customer Service
Walmart
03.2014 - 06.2014
CNA
JK Home Health Service
08.2013 - 10.2014
Package Handler
FedEx Ground
08.2011 - 12.2014
High School Diploma -
Joliet West Township High School
08.2006 - 05.2009