Alexandria Harris
Chicago,IL
Summary
Medical data entry with 5 years of PBM and retail pharmacy experience, as well as 7 years of healthcare and customer service experience. Self-starter with extensive knowledge of Medicaid and Medicare procedures. Excellent data entry skills and telephone etiquette. Detail-oriented and focused on accuracy and efficiency. Skilled in medical billing and coding, HIPAA, PHI, with proficiency in EHR/EMR systems. Expertise in insurance claims processing, ensuring accuracy in documentation, medical records. WPM 55.
Overview
9
9
years of professional experience
Work History
Certified Pharm Tech Data Entry
Maximus
02.2022 - 04.2024
- Self-motivated, with a strong sense of personal responsibility.
- Excellent communication skills, both verbal and written.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Maintained accuracy in the translation of 99.8%
- Maintained a speed of 36 scripts per hour with an accuracy of 99.8%
- Translated prescriptions at a fast pace
Prior Authorization Specialist
Humana
10.2020 - 03.2022
- Verified eligibility and compliance with authorization requirements for service providers.
- Assisted in development of educational materials for patients and providers about prior authorization process.
- Facilitated cross-departmental training sessions to enhance understanding of prior authorization criteria and procedures.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Received and accurately processed 30 or more prior authorization a day.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
Certified Pharmacy Technician
Walgreens
03.2015 - 03.2019
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
- Maintained HIPAA laws and privacy of protected health information.
Education
Certificate - Medical Billing And Coding
DeVry University
Chicago, IL12-2022
High School Diploma -
Kenwood Academy
Chicago, IL06-2009
Skills
- HIPAA, PHI knowledge
- EHR/EMR
- Customer Service
- Accuracy in Documentation
- Time management
- Medical billing and coding
- Microsoft office, (Word, Excel, Powerpoint, Teams
- Medicare, Medicaid
- Commerical insurance
- Explanations of benefits (EOB)
- Medical records clerk
- WPM 55
Timeline
Certified Pharm Tech Data Entry
Maximus
02.2022 - 04.2024
Prior Authorization Specialist
Humana
10.2020 - 03.2022
Certified Pharmacy Technician
Walgreens
03.2015 - 03.2019
Certificate - Medical Billing And Coding
DeVry University
High School Diploma -
Kenwood Academy
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