Earlene Florence
Milton,FL
Summary
Dynamic Authorization Specialist with a proven track record at North Florida Surgeons, enhancing workflow efficiency and patient satisfaction through expert prior authorization processing and stellar communication skills. Achieved significant reductions in processing times by over 30%, demonstrating adaptability, HIPAA compliance, and a commitment to continuous improvement. Excelled in teamwork and problem-solving, ensuring high-quality customer service and compliance.
Overview
24
24
years of professional experience
Work History
Authorization Specialist
North Florida Surgeons
03.2021 - Current
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Attended ongoing professional training to facilitate accurate and productive credit management.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
- Promoted positive customer experiences by addressing concerns or questions related to authorizations in a professional manner.
- Improved patient satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
Pre-Cert /Patient Service Specialist
Sacred Heart Cancer Center
11.2015 - 03.2021
- Improved customer satisfaction by addressing and resolving service-related issues promptly and professionally.
- Consistently met or exceeded performance metrics related to service quality, response time, and customer satisfaction scores.
- Evaluated systems according to predetermined checklist and noted issues.
- Achieved high levels of productivity by optimizing workload management methods and prioritizing tasks according to urgency.
- Cultivated strong relationships with clients through excellent communication skills and genuine concern for their needs, leading to increased client retention rates over time.
- Managed service specialist team, fostering a positive work environment and encouraging teamwork to achieve desired results.
- Maintained accurate records of all customer interactions for reporting purposes and ongoing process improvements.
- Handled escalated customer concerns with professionalism, resulting in improved relationships and repeat business.
- Delivered exceptional customer service by promptly addressing inquiries and resolving issues.
- Responded to customer requests for products, services, and company information.
- Followed instructions from supervisor regarding daily job tasks and duties.
- Continuously adhered to strict regulations as well as detailed instructions, guidelines and specifications.
- Positively engaged with customers and maintained professional appearance as company representative.
Lead Cardiology Tech
Cardiology Associates of Schenectady
10.2006 - 08.2015
- Supervise and train cardiology technicians
- Oversee flow of patients through clinic to ensure efficiency
- check patients into rooms / Obtain vital signs
- Perform EKGs and PVRs
- Assist physicians with procedures
- Collect and edit data from holter monitors
- Work in Protime lab
- Perform billing for insurance companies
- Maintain electronic and paper records
- Use electronic scheduling system
- Ensure office and clinic supplies are stocked and re-order as necessary
Medical Office Manager
Dr. Hafeeze Rehman
10.2000 - 12.2002
- Responsible for insurance billing and posting payments
- Ensure office and clinic supplies are stocked and re-order as necessary
- Oversee flow of patients through clinic to ensure efficiency
- Obtain vital signs
- Perform EKGs
- Use electronic scheduling system
- Verify insurance information including contacting insurance companies as needed
- Communicate with various doctor's offices, hospitals and pharmacies to assist in multi-disciplinary care
Education
High School Diploma -
Johnstown High School
Johnstown, NYNo Degree - Business Administration
Fulton-Montgomery Community College
Johnstown, NYSkills
- Prior authorization processing
- Insurance verification
- HIPAA compliance
- Appointment scheduling
- Documentation and paperwork
- Effective communication skills
- Documentation and reporting
- Telephone etiquette
- Benefits administration
- Eligibility procedures
- Confidentiality
- Performance monitoring
- Authorizations
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Reliability
- Excellent communication
- Critical thinking
- Organizational skills
- Team collaboration
- Decision-making skills
- Active listening
- Effective communication
- Adaptability and flexibility
- Decision-making
- Relationship building
- Team building
- Task prioritization
- Self motivation
- Interpersonal skills
- Customer relationship management
- Documentation review
- Deadline management
- Computer literacy
- Information gathering
- Professionalism
- Interpersonal communication
- Goal setting
- Document preparation
- Quality control
- Time management abilities
- Continuous improvement
Timeline
Authorization Specialist
North Florida Surgeons
03.2021 - Current
Pre-Cert /Patient Service Specialist
Sacred Heart Cancer Center
11.2015 - 03.2021
Lead Cardiology Tech
Cardiology Associates of Schenectady
10.2006 - 08.2015
Medical Office Manager
Dr. Hafeeze Rehman
10.2000 - 12.2002
High School Diploma -
Johnstown High School
No Degree - Business Administration
Fulton-Montgomery Community College
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