Cassandra Davis
Houston,TX
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Amiable Prior Authorization Representative with 7 years of connecting patients and healthcare providers to vital resources. Dedicated to executing on prescribed medical funding guidelines and policies. Maintains compassionate and sympathetic relations with consumers. Reliable Prior Authorization Specialist with over 7 years of experience working in fast-pace enviroment.
Overview
9
9
years of professional experience
Work History
Prior Authorization Coordinator
Lifestyle Wellness Clinic
06.2019 - 07.2022
- Verified eligibility and compliance with authorization requirements for service providers.
- Tracked referral submission during facilitation of prior authorization issuance.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Authorized Infusion requests in accordance with applicable plan guidelines.
- Expedited approval process for vital medications by maintaining a strong working relationship with insurance providers.
- Ensured compliance with state and federal regulations through diligent monitoring of prior authorization processes.
Intake Specialist
Randstad/ Mckesson
04.2016 - 06.2019
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Collected and processed patient liability statements prior to service.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Authorized pharmaceutical infusion medication requests in accordance with applicable plan guidelines.
- Maintained the confidentiality of sensitive patient information, adhering strictly to HIPAA regulations and safeguarding medical records appropriately.
Customer Service Representative
HealthNet
08.2013 - 04.2016
- Analyzed and audited open claims to calculate additional payments owed
- Reviewed collection files to determine next steps in collection process
- Identified and obtained evidence to ascertain claim value
- Reviewed data to verify validity of claims and determine case management actions
- Investigated questionable claims to determine payment authorization.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
Education
Associate Degree - Business Administration And Management
Cameron College
02.2017
Skills
- Microsoft Office
- HIPAA Compliance
- Authorizations
- Medicare and Medicaid knowledge
- Patient Referrals
- EPIC
- Insurance Coverage Verification
- Eligibility Determination
- Medical Terminology
- Electronic Medical Records
- Medicaid knowledge
- Customer Service
Timeline
Prior Authorization Coordinator
Lifestyle Wellness Clinic
06.2019 - 07.2022
Intake Specialist
Randstad/ Mckesson
04.2016 - 06.2019
Customer Service Representative
HealthNet
08.2013 - 04.2016
Associate Degree - Business Administration And Management
Cameron College
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