Cristen Shaw
Knoxville,TN
Summary
Healthcare professional prepared for role with strong background in managing and navigating the authorization processes and ensuring compliance with insurance regulations. Proven ability to communicate effectively and manage multiple tasks, enhancing workflow efficiency. Proficient in electronic health records, contributing to timely approvals and exceptional patient support.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Ensemble Health Partners
Greeneville, TN
12.2019 - 02.2026
- Reviewed and processed prior authorization requests for medical procedures and services.
- Utilized electronic health record systems to track and manage authorization workflows.
- Ensured compliance with payer policies and regulations throughout the authorization process.
- Collaborated with physicians to obtain necessary documents and clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
Receptionist
Marble Designs of Florida, Inc
Titusville, FL
06.2016 - 11.2019
- Managed multi-line phone system, directing calls to appropriate departments efficiently.
- Greeted and helped customers as they came into the store
- Scheduled appointments and coordinated meetings for staff and clients effectively.
- Maintained organized filing systems, ensuring easy access to critical documents.
- Maintained cleanliness and presentation of the showroom floor
Receptionist
Applianceville
Titusville, FL
02.2015 - 11.2015
- Answered phone calls, addressing customer inquires and scheduled appointments
- Assisted customers in store with inquiries, providing exceptional service and support.
- Input previous days transactions into Quickbooks and got the daily deposit ready
- Confirmed appointments, communicated with clients, and updated client records.
- Looked up parts at customer request and rang out transactions
Front Office Clerk
Titusville Family Practice/NBMS
Titusville, FL
04.2007 - 01.2015
- Answered phone calls and directed to appropriate departments. Managed patient scheduling and appointment coordination efficiently.
- Maintained accurate records consistently, received patients copays and bill payments
- Responded to inquiries, providing exceptional customer service support.
- Responsible for privacy sensitive documents such as patient charts and Insurance information.
- Submitted and requested information for referrals through Insurance companies.
- Copying of patient information for record requests
Education
High School Diploma -
Skills
- Prior authorization process
- Insurance Verification
- Effective communication skills
- Data entry
- Electronic health records proficiency
- Professionalism and ethics
- Multitasking
Certification
- Certified Revenue Cycle Representative, Ensemble Health Partners - Expires Nov 2027
Timeline
Prior Authorization Specialist
Ensemble Health Partners
12.2019 - 02.2026
Receptionist
Marble Designs of Florida, Inc
06.2016 - 11.2019
Receptionist
Applianceville
02.2015 - 11.2015
Front Office Clerk
Titusville Family Practice/NBMS
04.2007 - 01.2015