Casey Coley
Mount Pleasant,NC
Summary
Professional in healthcare industry with strong background in managing authorizations and ensuring compliance. Skilled in navigating complex systems, problem-solving, and maintaining accurate records. Known for effective collaboration, adaptability, and delivering results in fast-paced environments. Reliable team player with expertise in healthcare regulations, communication, and customer service.
Overview
5
5
years of professional experience
Work History
Advanced Authorization Specialist
Atrium Health Levine Cancer Financial Clearance
Charlotte, NC
08.2023 - Current
- Manage high volume Stat request mailbox for all oncology facilities for potential life altering, high-cost treatment and procedures within a short time frame. Expected treatment within 1-3 days.
- Interpret medical records to determine initial and disease progression to prove medical necessity for ordered services and complete on-line clinical requests for advanced authorization.
- Manage Advocate Health preferred drug list (chemotherapy/immunotherapy/supportive drugs) with payors and correlate changes with oncology pharmacy.
- Review and address monthly denials for Chemotherapy Drugs, Molecular Labs and surgeries with payors and Advocate Health Denial Management Teams (HBO/PBO).
Authorization Specialist
Atrium Health
Albemarle, North Carolina
07.2021 - 08.2023
- Serves as liaison with insurance companies to ensure completion of all referral-related activities
- Actively listens to customers and handles concerns quickly and proficiently
- Reviewed insurance policy to determine coverage.
- Proficient in ICD10 coding
- Completed referrals for patients and coordination with referring and receiving practices and departments
- Obtains authorizations for radiation treatment planning
Referral Coordinator
Novant Health
Concord, North Carolina
11.2020 - 07.2021
- Knowledgeable in Epic EMR, Cadence and EpicCare applications
- Coordinates referral appointments
- Serves as liaison with insurance companies to ensure completion of all referral-related activities
- Maintains and updates patient's records
- Performed medication prior authorizations
- Proficient in ICD10 and CPT coding
- Proficient in Microsoft Office and suite
- Other duties: faxing, answering phones and scheduling appointments
Education
Bachelor of Science (B.S.) - Healthcare Administration
Gardner Webb University
Boiling Springs, North Carolina08-2015
Skills
- Customer Service
- Multitasking
- Detail Oriented
- Effective Communication
- Proficient In Epic EMR
- Telephone Etiquette
- Customer Relationship Management
- Critical Thinking
- Paperwork And Documentation
- Customer Satisfaction
Timeline
Advanced Authorization Specialist
Atrium Health Levine Cancer Financial Clearance
08.2023 - Current
Authorization Specialist
Atrium Health
07.2021 - 08.2023
Referral Coordinator
Novant Health
11.2020 - 07.2021
Bachelor of Science (B.S.) - Healthcare Administration
Gardner Webb University