Healthcare professional with extensive experience in prior authorizations. Proven ability to streamline processes and improve efficiency while maintaining compliance with industry standards. Valued team player who consistently achieves results through effective collaboration and adaptability.
Call insurance companies or check portals to obtain status of submitted prior authorizations and document the information received into the computer system, enter prior authorization approvals in the computer system.
Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing online eligibility systems to verify patient coverage and policy limitations; Assisted clinics and patients with understanding prior authorizations and their pharmacy benefits; Answered inbound inquiries related to prior authorizations and insurance claims; Followed established company policies and procedures and applied acquired job skills to verify insurance rejections and contact clinics to initiate and receive information to complete prior authorizations.
Counted out medications and labeled prescription vials/containers to prepare for shipping.
Answered incoming phone calls and addressed questions from customers and healthcare providers; Stocked, labeled, and inventoried medication to keep accurate records; Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging; Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy; Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions; Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items; Counted and labeled prescriptions with correct item and quantity; Provided exceptional customer service, fostering positive relationships with both new and returning patients at the pharmacy counter.
Placed orders and up-sells via inbound calls at my residence.
Quoted and sold all types of personal insurance policies; Serviced policies; Marketing; Placed daily reminder and pending cancellation calls to customers; Answered phones; Processed payments in office and via phone; Manager of one employee.
HCPCS coding
HIPAA compliance
ICD-10 coding
Epic computer software
Oncesource computer program