Amber Howey
Merritt
Summary
Healthcare professional with experience leading customer service operations and supporting prior authorization processes within a fast-paced healthcare environment. Strong background in provider communication, medical policy and payer guideline review, reimbursement support, coordination of benefits, and clinical documentation management. Skilled in Salesforce case documentation, authorization workflow coordination, and ensuring accurate information is collected and submitted to support timely payer decisions. Experienced in coaching and developing team members, analyzing performance metrics, resolving escalated issues, and partnering with leadership to identify trends, improve processes, and proactively address customer and insurance-related challenges.
Overview
9
9
years of professional experience
Work History
Customer Service Supervisor Specialist
Seven Corners Travel Insurance
Carmel
04.2022 - Current
- Coordinated prior authorization requests by partnering with healthcare providers, insurance payers, and internal teams to obtain and submit required clinical documentation.
- Reviewed payer requirements and medical policies to identify required documentation and ensure complete, accurate prior authorization submissions.
- Communicated with provider offices to obtain medical records, clinical documentation, and supporting information, ensuring timely submission to meet payer deadlines.
- Monitored prior authorization cases from submission through determination, providing status updates, resolving documentation issues, and following up to minimize processing delays.
- Utilized Salesforce to document case activity, track authorization requests, maintain accurate records, and ensure timely follow-up with providers and payers.
- Trained and mentored team members on prior authorization workflows, documentation requirements, provider communication, and customer service best practices while consistently meeting call center quality and productivity metrics.
Care Giver
Quiet Creek Adult Foster Care
Falmouth
06.2020 - 03.2022
- Assisted residents with daily living activities and personal care needs.
- Monitored health conditions and reported changes to healthcare professionals.
- Facilitated social activities and encouraged resident engagement in community events.
- Maintained a clean and safe living environment for all residents.
- Documented resident progress and care provided in daily logs.
- Provided emotional support and companionship to enhance resident well-being.
Substitue Teacher
McBain Public School
McBain
08.2017 - 06.2019
- Adapted quickly to diverse classroom environments by interpreting lesson plans, implementing established procedures, and ensuring continuity of daily operations.
- Built positive relationships with students, teachers, administrators, and parents through effective communication, professionalism, and conflict resolution.
- Managed multiple priorities in fast-paced environments while maintaining accuracy, organization, and attention to detail under changing circumstances.
- Maintained confidential student information and adhered to district policies, demonstrating discretion and compliance with established guidelines.
- Assessed situations, exercised sound judgment, and resolved classroom challenges independently while ensuring a safe and productive learning environment.
- Collaborated with school staff to support student needs, document classroom activities, and ensure seamless transitions between permanent and substitute educators.
Education
Bachelor of Science - Education
Baker College
Cadillac, MI06-2018
Skills
- Prior Authorization Coordination
- Healthcare Reimbursement Processes
- Medical Policy & Payer Guideline Interpretation
- Coordination of Benefits (COB)
- Provider & Payer Collaboration
- Salesforce CRM & Case Management
- Medical Records & Clinical Documentation
- Claims Support & Documentation Review
- Cross-Functional Collaboration
- Insurance Issue Resolution & Escalation Management
Timeline
Customer Service Supervisor Specialist
Seven Corners Travel Insurance
04.2022 - Current
Care Giver
Quiet Creek Adult Foster Care
06.2020 - 03.2022
Substitue Teacher
McBain Public School
08.2017 - 06.2019
Bachelor of Science - Education
Baker College