Brandi Walker
Birmingham
Summary
Dynamic professional with extensive experience in care management and prior authorization. Excelled in utilizing medical terminology and insurance verification to enhance patient care. Demonstrated adaptability and effective communication. Skilled in HIPAA compliance and team collaboration, with a commitment to improving health outcomes.
Overview
10
10
years of professional experience
Work History
Care Management Support Assistant II
Humana
05.2023 - Current
- Use a holistic approach to address member's health and well-being needs.
- Complete a Health Risk Assessment with the members. Utilizing my familiarity with care and well-being resources to help those with urgent needs.
- Complete Transition of Care Assignments for members that have had a inpatient status change at a medical facility.
- Volunteered to help with special projects of varying degrees of complexity.
- Surpassed individual daily goals by implementing the best practices and protocols.
Prior Authorization Specialist/ Pre-Registration
R1 Rcm
04.2018 - 05.2022
- Maintained accurate records of authorization requests by organizing documentation and tracking status updates.
- Conducted follow-up calls to ensure timely processing of authorization requests, minimizing delays in patient care.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Verified eligibility and compliance with authorization requirements for service providers.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Patient Registration Representative
Children's of Alabama Hospital
02.2015 - 01.2018
- Built rapport with diverse populations through excellent interpersonal skills, empathy, and active listening abilities during interactions with patients and families.
- Explained financial responsibilities to patients as well as payment options and potential collection procedures imposed upon patients and other responsible parties.
- Gathered demographic and insurance information to register patients for medical appointments.
- Collected payments and co-pays from customers using large variety of insurance programs, adjusting amounts based on specific plan directives.
- Strengthened interdepartmental communication by proactively informing relevant staff members about schedule changes, cancellations, or special accommodations needed for patients.
Education
Bachelor of Science - Public Health
The University of Alabama
Tuscaloosa, AL12-2025
Associate of Applied Science - Medical Support Specialist
Jefferson States Community College
Birmingham, AL05-2015
Skills
- Prior authorization process
- Medical terminology
- Insurance verification
- Effective communication skills
- Workflow management
- Patient confidentiality compliance
- HIPAA compliance
- Team collaboration
- Adaptability and flexibility
- Reliability
Timeline
Care Management Support Assistant II
Humana
05.2023 - Current
Prior Authorization Specialist/ Pre-Registration
R1 Rcm
04.2018 - 05.2022
Patient Registration Representative
Children's of Alabama Hospital
02.2015 - 01.2018
Bachelor of Science - Public Health
The University of Alabama
Associate of Applied Science - Medical Support Specialist
Jefferson States Community College
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