CRYSTAL KONG
Little Canada,MN
Summary
Hardworking Prior Authorization Specialist with a successful background working closely with insurance company representatives to gain preapproval for medication authorizations. Detail-oriented performer with over 7 years of managing documentation. Considered a team player with exemplary multitasking skills and am in the process of completing a Medical Coding Degree.
Overview
11
11
years of professional experience
Work History
Financial Prior Authorization Representative
Allina Health Clinics
04.2022 - Current
- Contacted insurance companies to obtain prior authorization for medications.
- Verified eligibility and compliance with authorization requirements for service providers.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Input all patient data regarding claims and prior authorizations into system accurately.
Certified Medical Assistant
Allina Health Clinics
12.2014 - 04.2022
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Documented vital signs and health history of patients in the clinic.
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Communicated clearly and effectively with patients to verify information, determine the purpose of the visit, and record medical history.
- Called and faxed pharmacies to submit prescriptions and refills.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
- Collected and documented patient medical information such as blood pressure and weight. Obtain vitals, organize and prepare clean exam rooms
- Assist with scheduling appointments
- Assist physician in minor procedures
- Keyboard and navigate electronic medical record
- Maintain good organization, problem solving and judgment
- Complete FMLA forms and prior authorization
- Register and obtain accurate patient demographics
- Assist provider in medical scribing
Provider Service Coordinator
Medica Health Insurance, Medica
09.2018 - 11.2018
- Answered incoming phone calls from health care offices
- Identified the type of assistance EX: benefits, eligibility and claims
- Researched ICD-10, CPT and HCPCS codes for benefit eligibility
- Utilized multiple computer software EX: encoder pro
Peer Mentor
Century College
01.2013 - 10.2014
- Mentored 10-15 new students
- Helped new students at Century College get involved with academics, activities and events
Education
Certificate - Medical Office Technology Coding
Century Community And Technical College
White Bear Lake, MN05.2022
Diploma - Certified Medical Assistant
Century Community And Technical College
White Bear Lake, MN10.2014
Skills
- Patient Insurance Authorizations
- Problem Resolution
- Electronic Health Records Systems
- Patient Interviews
- Past Due Balance Management
- Medical Terminology
- Registration Processes
- Client Service
- Basic Medical Terminology
- Registration Paperwork
- Medical Coding
- Customer Experience
- Treatment Documentation
Timeline
Financial Prior Authorization Representative
Allina Health Clinics
04.2022 - Current
Provider Service Coordinator
Medica Health Insurance, Medica
09.2018 - 11.2018
Certified Medical Assistant
Allina Health Clinics
12.2014 - 04.2022
Peer Mentor
Century College
01.2013 - 10.2014
Certificate - Medical Office Technology Coding
Century Community And Technical College
Diploma - Certified Medical Assistant
Century Community And Technical College
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