Alicia Dugan
Providence
Summary
Motivated and adaptable professional seeking new opportunities to contribute skills, grow expertise, and support organizational goals. Brings strong communication, problem‑solving, and teamwork abilities, with a commitment to delivering quality results and continuous improvement.
Overview
3
3
years of professional experience
Work History
Prior Authorization Specialists
Brown University Health
12.2024 - Current
- Obtains, manages and tracks necessary approvals from insurance providers for Skilled Nursing and Inpatient Rehabilitation facilities
- Communicates with insurance providers via telephone or web portals to verify benefits and eligibility
- Follow up on all denied requests or intent to deny. Working with providers to appeal or provide additional information
- Review medical records to ensure all documentation meets insurance payer requirements
- Processes prior authorization requests efficiently, ensuring compliance with insurance guidelines
- Facilitates communication between healthcare providers and insurance companies to expedite approvals
- Review patient information for accuracy, verifying eligibility and coverage details
- Maintain detailed records of authorization requests and outcomes in electronic health systems
- Collaborated with clinical staff to gather necessary documentation for complex authorizations
Transition Care Coordinator
Brown University Health
06.2023 - 12.2024
- Collaborating with case management and nursing homes to ensure continuity of care
- Verify patient coverage for follow up care for major insurances UHC, Blue Cross, NHP, Aetna, Wellcare
- Train new employees on unit policies and procedures
- Managed the transition from careport to careport transitions in lifechart to connect with skilled nursing facilities
- Coordinate care transitions between care settings to ensure continuity of services
- Developed and maintained comprehensive discharge plans tailored to individual patient needs
- Collaborated with multidisciplinary teams to facilitate successful care transitions and reduce readmission rates
Education
Bachelor of Arts - Psychology
Rhode Island College
Providence, RI05-2020
Skills
- Effective communication skills
- Excellent customer service
- Personnel management
- Data entry
- Proficient in electronic health records: Epic, Careport, Knowledge Bases
- Medical terminology knowledge
- Time management
- Project management
Affiliations
- President Advisory Council
- Sunshine Fund
- Seasons of Giving Committee
Timeline
Prior Authorization Specialists
Brown University Health
12.2024 - Current
Transition Care Coordinator
Brown University Health
06.2023 - 12.2024
Bachelor of Arts - Psychology
Rhode Island College
OTHER EXPERIENCE
- Assistant Beverage Manager
- Brown University Health
- November 2019 – September 2021
- Responsible for training 10+ servers who established a high level of customer experience
- Excelled in managing high-stress events such as wedding ceremonies and other proceedings related to food and beverage
- Lead in coordinating 50+ dining functions, which consisted of efficient set-up, operation and breakdown of high-end ballroom events, including but not limited to; bartender assistance, cocktail service, dinner distribution (sit-down and buffet), customer and guest interactions and end of event closure.
- Maintained all sanitation procedures and food and safety guidelines.