Arianna Reynolds
Lake Providence,LA
Summary
Professional with extensive experience in healthcare operations, specializing in prior authorization processes and claims analysis. Demonstrated ability to communicate effectively with internal teams regarding policy changes and to analyze claims data for cost-saving opportunities. Proven track record in reviewing prior authorization requests for accuracy and completeness while ensuring compliance with HIPAA regulations. Skilled in providing quality assurance on work products and facilitating communication among healthcare providers to enhance patient care outcomes.
Overview
5
5
years of professional experience
Work History
Medical Records Clerk
Lake Providence Nursing and Rehab
Lake Providence, LA
08.2024 - Current
- Reviewed patient charts for accuracy and completeness.
- Provided training to staff members on proper documentation techniques for medical records.
- Entered data into electronic health record systems.
- Verified insurance eligibility prior to releasing protected health information.
- Assisted in developing processes for maintaining current information in patient's files.
- Processed incoming medical records requests.
- Performed quality assurance reviews of medical records for accuracy and completeness.
Prior Authorization Representative
BroadPath Healthcare
Lake Providence, LA
10.2023 - 06.2024
- Communicated with internal teams regarding changes in policy or procedure related to prior authorization process.
- Analyzed claims data from multiple sources to identify areas of potential cost savings.
- Reviewed prior authorization requests for completeness and accuracy.
- Responded promptly to inquiries from providers, members, and other departments within the organization.
- Performed quality assurance reviews on completed work products before submission to payers.
- Assessed insurance benefits and determined eligibility criteria.
Emergency Room Technician
East Carroll Parish Hospital
Lake Providence, LA
03.2020 - 09.2023
- Completed documentation for each patient encounter accurately and within established timeframes.
- Facilitated communication between nurses, physicians and other healthcare providers involved in patient care.
- Assisted with resuscitation efforts in life-threatening situations such as cardiac arrest or trauma cases.
- Ensured proper disposal of hazardous materials such as needles or contaminated linens.
- Conducted laboratory tests on specimens collected from patients in accordance with lab policies.
- Responded quickly and efficiently to code blue calls in order to provide effective lifesaving measures.
- Provided patient care by taking vital signs, inserting IVs, drawing blood and administering medications.
- Provided emotional support to family members during a crisis situation or at end-of-life stages of care.
Customer Service Representative
Ttec (TeleTech) - HealthCare Solutions
Lake Providence, LA
01.2022 - 02.2023
- Maintained a high level of professionalism when dealing with difficult customers.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Provided exceptional customer service to ensure customer satisfaction.
- Tracked orders from start to finish to ensure timely delivery of goods or services.
- Resolved customer complaints promptly and efficiently.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
Education
Medical Assistant -
Carters And Associates Careers
Monroe, La06-2017
Certified Nursing Assistant -
Louisiana Delta Community College
Monroe, LA05-2015
High School Diploma -
General Trass High School
Lake Providence, LA05-2015
Skills
- Prior authorization
- Claims analysis
- Insurance verification
- Quality assurance
- Data entry
- Medical terminology
- Customer service
- Problem solving
- Time management
- Critical thinking
- Emotional intelligence
- Electronic refill request processing
- Benefit coverage
- HIPAA compliance
- Insurance authorization
- Healthcare industry
Timeline
Medical Records Clerk
Lake Providence Nursing and Rehab
08.2024 - Current
Prior Authorization Representative
BroadPath Healthcare
10.2023 - 06.2024
Customer Service Representative
Ttec (TeleTech) - HealthCare Solutions
01.2022 - 02.2023
Emergency Room Technician
East Carroll Parish Hospital
03.2020 - 09.2023
Medical Assistant -
Carters And Associates Careers
Certified Nursing Assistant -
Louisiana Delta Community College
High School Diploma -
General Trass High School