Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Candice Morgan

Bartlett,TN

Summary

Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Prior Authorization position. Ready to help team achieve company goals.

Overview

10
10
years of professional experience

Work History

Provider Network Operations

Santa Clara Family Health Plan (Contract with TotalMed)
2024.01 - 2024.06
  • Using MS Excel reports to input data into company databases – Provider Demographics and Credentialing Details
  • Data Entry / Provider into eVIPS and QNXT
  • Inputting information into Excel & Outlook emails
  • Attestations
  • MS Teams meetings
  • CAQH, NPPES.

Medical Records

Gastro One
2023.05 - 2023.10
  • Maintain physical medical records
  • Update patients’ electronic health records (EHR)
  • Respond to ROI (release of information) requests for medical records
  • Validate requests and authorizations for the release of medical information
  • Ensure that clinical documentation of the services provided to patients are correct
  • Prepare charts for patient visits
  • Follow company policy regarding the releasing of and obtaining medical records
  • Scan all received information in proper location in patients’ chart
  • Maintains strict confidentiality in accordance with regulatory guidelines and specific policies of company policies
  • Understand the practice management system and look up information in the practice management system in order to help patients and outside clients
  • Reviewed and attached labs to records
  • Purge charts as needed
  • Managed 10 tasks per day

Team Lead of Packaging

Memphis Record Pressing
2022.09 - 2023.05

Quality assurance of the record for flaws prior to packaging

  • Data Entry
  • Review requirements of order on instructions how product should be put together
  • Advise assemblers of instructions/schedules to carry out assignments
  • Monitor inventory of packaging supplies for each job order
  • Maintain a positive relationship with employees and visitors
  • Work closely with other departments
  • Crossed trained to work specifically sleeving and material handling
  • Wave Planner
  • Managed Approximately 20 assemblers

Registration Specialist I

Carvana LLC
2021.06 - 2022.06
  • Processing, finalizing, and mailing out customer registration
  • Data Entry
  • Reviewing customer paperwork for accuracy
  • Working closely with the local DMV
  • Filling paperwork with the DMV
  • Updating customer records to ensure the most up to date information is available
  • Interacting and communicating with team members across various lines of the business
  • Assisting Customer Advocates and other HUB employees with customer follow-up
  • Being a high-energy, forward-thinking self-starter
  • Other duties as assigned
  • Salesforce.
  • Averaged 20 or more registrations per day

Behavioral Health Prior Authorization

United Healthcare MVUM TriCare
2014.01 - 2018.07

Verify eligibility including coordination of benefits, and patient demographic information

  • Utilization Management (UM)
  • Assist team members with database loading
  • Add providers in the Careone Network
  • Verification of active/inactive Providers
  • Build impatient (IP), and outpatient (OP) notifications
  • Maintain patient records, demographic information in accordance with HIPPA guidelines
  • Receive/process prior authorization requests via e-Fax from DOD medical providers, and facilities
  • Letter processing, and other duties as assigned
  • Responsible for providing expertise and customer service support to members, customers, and/or providers
  • Direct phone-based customer interaction to answer and resolve a wide variety of inquiries
  • This was a (SCA) must support a government Service Contract Act agreement
  • The Medial Records Sorter sorts organizes medical records previously downloaded from the Veteran Administration's Veterans Benefit Management System (VBMS) and creates an electronic case File (C-File) containing medical records pertinent to the Veteran's claimed conditions
  • Electronic health records (EHR)
  • Processed 25 to 30 authorizations per day
  • Demonstrated strong organizational and time management skills while managing multiple projects.
  • Developed and maintained courteous and effective working relationships.

Education

High School Diploma -

Raleigh Egypt High School
Memphis, TN
05.1986

Skills

  • Team Collaboration
  • Relationship Building
  • Team building
  • Self Motivation
  • Interpersonal Skills
  • Analytical Thinking
  • Problem-solving abilities
  • Organizational Skills
  • Working collaboratively
  • Team Management
  • Escalation Handling
  • Reliability

References

References available upon request

Timeline

Provider Network Operations

Santa Clara Family Health Plan (Contract with TotalMed)
2024.01 - 2024.06

Medical Records

Gastro One
2023.05 - 2023.10

Team Lead of Packaging

Memphis Record Pressing
2022.09 - 2023.05

Registration Specialist I

Carvana LLC
2021.06 - 2022.06

Behavioral Health Prior Authorization

United Healthcare MVUM TriCare
2014.01 - 2018.07

High School Diploma -

Raleigh Egypt High School
Candice Morgan