Alexis Hunter
St Louis,MO
Summary
Dedicated Precertification Specialist with 15 years of experience in healthcare administration, specializing in managing insurance precertification processes while ensuring strict compliance with HIPAA regulations. Expertise in medical terminology facilitates navigation of complex healthcare environments. Recognized for fostering team collaboration and reliability, with a proven track record of adapting to evolving healthcare needs. Strong skills in detailed documentation and communication contribute to streamlined operations and improved patient outcomes.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Precertification Specialist
Washington University School of Medicine
11.2021 - Current
- Coordinated precertification requests to ensure timely insurance approvals for patient procedures.
- Reviewed documentation for compliance with insurance requirements, ensuring accuracy and completeness.
- Collaborated with healthcare providers to gather necessary clinical information for precertification processes.
- Streamlined communication between departments, enhancing workflow efficiency in the precertification process.
- Analyzed trends in precertification denials, implementing strategies to minimize future occurrences and enhance approval rates.
Patient Service Representative
Washington University School of Medicine
08.2018 - 11.2021
- Schedule, reschedule, cancel and confirm return patient appointments and diagnostic procedures in Epic as needed.
- Educate patients and families on treatments, procedures, medications, continuing care and community care.
- Verified demographics and insurance information to register patients
- Address patient’s complaints, investigated concerns and work with medical staff to devise solutions.
- Answer Incoming calls to IM Oncology and triage/task/page/call to the physicians clinical teams, new patient coordinators and administrative staff as appropriate
Precertification Specialist
St Louis Children’s Hospital
03.2017 - 08.2018
- Verified Patients eligibility, insurance benefits, deductibles and claim status with insurance agencies.
- Determined and pre-certified prior authorizations for medications, medical supplies, inpatient and outpatient procedures
- Maintained and updated prior authorizations and insurance data in tracking spreadsheets and EPIC to help organize and obtain payment from Medicaid, Medicare and third party payers.
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions
- Provided accurate insurance information to all parties’ patients, insurance providers, and healthcare staff by using effective written and verbal communication.
Health Information Specialist
St Louis Children’s Hospital
08.2011 - 03.2017
- Facilitated document import into electronic health records using variety of applications which include scanning and indexing.
- Addressed customer medical information requests promptly, maintaining strict confidentiality under HIPPA regulations.
- Upgraded medical record documentation system to meet federal and state regulations, continually monitoring contacting physician’s for deficient and delinquent data.
- Managed a multi-line phone system and pleasantly greeted all patients , families and physician’s
Education
Bachelor of Science - Healthcare Administration
Washington University in St Louis
St Louis, MO09.2025
Associate of Arts - Clinical Medical Assistant
St Louis College of Health Careers
St Louis, MO01.2017
Skills
- Insurance eligibility verification
- EPIC Systems knowledge
- Patient coordination skills
- Knowledge of clinical terminology
- Experience in HIPAA adherence
- Patient Advocacy
- Strong communication skills
- Documentation and reporting
Certification
- National Health Career Association
- Clinical Medical Assistant
- Certification - 2017-2025
Timeline
Precertification Specialist
Washington University School of Medicine
11.2021 - Current
Patient Service Representative
Washington University School of Medicine
08.2018 - 11.2021
Precertification Specialist
St Louis Children’s Hospital
03.2017 - 08.2018
Health Information Specialist
St Louis Children’s Hospital
08.2011 - 03.2017
Associate of Arts - Clinical Medical Assistant
St Louis College of Health Careers
Bachelor of Science - Healthcare Administration
Washington University in St Louis
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