Andrea Grace
Fishers,IN
Summary
A detail-oriented and experienced professional with a strong background in prior authorization processes. Skilled in navigating insurance requirements, obtaining necessary approvals, and ensuring timely processing of request. Proven ability to communicate effectively with healthcare providers, insurance companies, and patients to streamline the authorization process and optimize patient care. A dedicated team player with a commitment to accuracy and efficiency in all aspects of prior authorization management.
Overview
15
15
years of professional experience
Work History
Patient Account Representative-Prior Authorization
Community Health Network
10.2015 - Current
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Maintained up-to-date knowledge of industry trends, regulatory changes, and payer-specific guidelines to ensure accurate processing of requests.
- Delivered consistent high-quality work under pressure, effectively managing high caseloads while meeting deadlines set forth by payers and internal guidelines.
- Submitted prior authorization requests to insurance companies following established protocols and guidelines.
- Submitted appeals for prior authorization requests and communicates with payers to resolve issues.
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Document all interactions and communication related to prior authorizations accurately and in a timely manner.
Medical Assistant
Northside ENT
08.2009 - 11.2014
- Improved patient experiences by efficiently managing appointments and maintaining organized medical records.
- Enhanced clinic efficiency by assisting physicians with routine procedures and diagnostic tests.
- Facilitated seamless patient care with thorough and accurate documentation of medical histories, vital signs, and medications.
- Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
- Maintained strict adherence to infection control protocols by following proper sterilization techniques for medical equipment.
- Sanitized, restocked, and organized exam rooms and medical equipment.
Education
Associate of Science - Business Management
Indiana Wesleyan University
Marion, IN04.2018
High School Diploma -
Whiteland Community High School
Whiteland, IN05.2005
Skills
- Electronic Records Management
- Teamwork and Collaboration
- Customer Service
- Data entry proficiency
- Medical terminology knowledge
- Effective communication skills
- Attention to Detail
- Self Motivation
- Multitasking
- Knowledge of Payers Policies
Timeline
Patient Account Representative-Prior Authorization
Community Health Network
10.2015 - Current
Medical Assistant
Northside ENT
08.2009 - 11.2014
Associate of Science - Business Management
Indiana Wesleyan University
High School Diploma -
Whiteland Community High School