Cholena Wilkins
Hyattsville,MD
Summary
Experienced pre-authorization coordinator with 15+ years in healthcare administration, skilled in insurance verification, payer follow-up, and HIPAA-compliant communication. Known for organized follow-through, critical thinking, and reducing delays in patient care.
Overview
24
24
years of professional experience
Work History
Pre-Authorization Coordinator
Neurology Medstar Georgetown Hospital
Washington, DC
05.2002 - Current
- Review and process pre-authorization requests for medical procedures in accordance with insurance guidelines and payer requirements.
- Conduct insurance eligibility and benefits verification to determine authorization requirements and patient coverage.
- Obtain and review required clinical documentation and supporting information from providers to ensure complete authorization submissions.
- Maintain consistent follow-up on submitted authorization requests and communicate with insurance companies regarding pending or denied requests.
- Document authorization outcomes accurately in electronic systems and maintain organized records to support audit readiness and continuity of care.
- Provide HIPAA-compliant patient education regarding insurance coverage, prior authorization requirements, and next steps.
- Respond to high-volume inquiries from patients, physicians, providers, and insurance representatives while maintaining professionalism and confidentiality.
- Train and mentor new team members on authorization procedures, payer requirements, and system workflows to promote consistency and quality.
- Apply knowledge of insurance plans, policies, and procedures to help minimize delays in patient care.
Pre- Authorization Associate
Radiology Medstar Georgetown Hospital
Washington, DC
10.2021 - 05.2022
- Maintained consistent follow-up on submitted authorization requests to support timely patient care.
- Conducted insurance eligibility and benefits checks for radiology services.
- Processed and documented pre-authorization requests for MRI, CT, nuclear medicine, interventional radiology, radiation oncology, and PET scans.
- Notified appropriate parties regarding denied authorizations and insurance coverage status.
- Scanned and maintained authorization documentation in MedConnect/IDX systems.
- Responded to inquiries from physicians, patients, and insurance companies regarding authorization status and coverage requirements.
- Maintained accurate documentation and communicated authorization updates to support continuity of care.
Lead Registration Associate
Otolaryngology Medstar Georgetown Hospital
Washington, DC
11.2017 - 10.2021
- Led registration operations for a 16-provider clinic, overseeing daily workflow, scheduling, and front-desk activities.
- Supervised registration processes to support efficient patient flow and daily clinic operations.
- Oversaw insurance verification, benefits checks, and authorization/referral confirmation to reduce registration errors and billing delays.
- Implemented and streamlined telehealth and virtual check-in processes to support continuity of care during the COVID-19 pandemic.
- Trained and provided backup support to patient navigators and clinical staff to promote consistent registration practices.
- Processed patient payments, batch credit card transactions, and coordinated transportation for patients undergoing procedures.
- Served as a liaison between Audiology, Radiology, and other departments to coordinate patient care and resolve workflow issues.
- Assisted patients with registration, scheduling, insurance-related questions, and administrative concerns while maintaining a high level of customer service.
Medical Receptionist
Arthritis and Rheumatism Associates
Wheaton
08.2015 - 08.2017
- Answered and directed calls using a multi-line telephone system and routed inquiries to the appropriate departments.
- Contacted primary care and referring physicians to obtain consultation notes, imaging, and laboratory results.
- Prepared office visit and procedure charts prior to scheduled appointments.
- Completed patient check-in and check-out procedures, collected copayments, and scheduled appointments.
- Provided patients and guarantors with required educational and administrative materials, including Patient Rights and Responsibilities, HIPAA Privacy Act notifications, and Advance Directive information.
- Supported daily front-office operations while maintaining patient confidentiality and accurate records.
Medical Receptionist
Asthma and Allergy Center
Silver Spring, MD
10.2011 - 08.2015
- Prepared charts and visit materials prior to appointments and ensured required documentation was scanned into the EMR.
- Verified insurance coverage and benefits for patients and accurately documented eligibility checks.
- Operated a multi-line telephone system, scheduled appointments, collected payments, and coordinated follow-up visits.
- Contacted referring physicians to obtain consultation notes, imaging, and laboratory results to support continuity of care.
- Provided professional customer service and administrative support in a busy medical office environment.
Medical Receptionist
Institute for Asthma and Allergy Center
Washington, DC
10.2007 - 08.2011
- Managed patient check-in, demographics, and insurance verification with accuracy.
- Scheduled appointments, follow-ups, and referrals while balancing provider calendars.
- Coordinated patient communications, answering calls and resolving routine inquiries promptly.
- Verified eligibility and collected copayments according to office procedures.
Education
N/a -
Career Technical Institute
Washington, DC01-2007
High School Diploma -
Rockville High School
Rockville, MD06-2002
Skills
- Prior authorization
- Strong communication skills
- Organizational growth
- Critical thinking
Timeline
Pre- Authorization Associate
Radiology Medstar Georgetown Hospital
10.2021 - 05.2022
Lead Registration Associate
Otolaryngology Medstar Georgetown Hospital
11.2017 - 10.2021
Medical Receptionist
Arthritis and Rheumatism Associates
08.2015 - 08.2017
Medical Receptionist
Asthma and Allergy Center
10.2011 - 08.2015
Medical Receptionist
Institute for Asthma and Allergy Center
10.2007 - 08.2011
Pre-Authorization Coordinator
Neurology Medstar Georgetown Hospital
05.2002 - Current
N/a -
Career Technical Institute
High School Diploma -
Rockville High School