Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ebony Hunter

Cypress,TX

Summary

Talented Prior Authorization Representative with years of implementing strategies to secure authorizations for clinical procedures. Expert delivering continuous clinical quality improvement. Superb influencing skills to communicate with credibility, tact and diplomacy. Detail-oriented prior authorization specialist proudly offering several years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments.

Overview

6
6
years of professional experience

Work History

Insurance Verification/Prior Authorization Specialist

Kelsey-Seybold
Pearland , TX
08.2023 - 03.2024
  • Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
  • Researched clinical criteria and determined eligibility for requested services based on plan provisions.
  • Maintained accurate records of all authorization activities in the database system.
  • Reviewed prior authorization requests to ensure accuracy and completeness of required information.
  • Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.

Insurance Verification Coordinator

USPI- United Surgical Partners International
Houston, TX
03.2023 - 08.2023
  • Updated patient and insurance data and input changes into company computer system.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Accessed third-party insurance databases to identify coverage of benefits.
  • Updated patient accounts with insurance verification information to ensure accurate billing.
  • Verified patient insurance coverage, benefits, and eligibility for services across multiple insurance platforms.
  • Educated patients on their insurance benefits and coverage limitations.
  • Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability.
  • Adhered to HIPAA requirements to safeguard patient confidentiality.
  • Communicated with patients with compassion while keeping medical information private.

Insurance Verification Representative

Boston Scientific
Houston, TX
03.2022 - 01.2023
  • Maintained accurate records of patient data in the system.
  • Researched insurance plans to determine coverages and benefits available.
  • Answered customer inquiries via phone or email in a professional manner.
  • Verified patient eligibility and benefits for insurance coverage.
  • Ensured compliance with applicable laws, regulations, policies, and procedures.
  • Performed outbound calls to verify patient's insurance coverage status.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Prepared and submitted detailed reports on insurance verification activities and outcomes.
  • Entered data in EMR database to record payer, authorization requirements and coverage limitations.
  • Maintained up-to-date knowledge of insurance policies, including Medicare and Medicaid.
  • Resolved insurance-related issues and discrepancies to prevent claim denials.

Rural Mail Carrier Associate/Seasonal Worker

USPS
Sealy , TX
11.2021 - 02.2022
  • Participated in training sessions related to new postal regulations and procedures.
  • Processed outgoing mail, including sorting, metering, labeling, and packaging.
  • Resolved customer complaints in a professional manner when necessary.
  • Delivered mail in a timely manner while adhering to safety regulations.
  • Loaded and unloaded trucks with mailbags or parcels using forklifts or pallet jacks.
  • Adhered to security protocols when handling confidential documents or packages.

Warehouse Operator

Medline
Katy, TX
02.2018 - 05.2020
  • Organized the warehouse in an efficient manner to facilitate locating merchandise quickly.
  • Maintained accurate records of all goods received, shipped or transferred between warehouses.
  • Maintained a clean work environment by adhering to safety protocols at all times.
  • Operated forklifts and other material handling equipment safely and efficiently.
  • Utilized scanners and RF devices for tracking purposes.
  • Packaged items for shipment according to customer specifications.
  • Monitored quality control processes for incoming shipments and outgoing orders.

Education

Some College (No Degree) - Medical Business Office Professional

Houston Community College
Houston, TX

Skills

  • Workflow Management
  • Medical terminology knowledge
  • Precertification requirements
  • Medical Terminology
  • Insurance Verification
  • Effective communication skills
  • Issue Research
  • Patient Referrals
  • Records Maintenance
  • Critical thinking abilities
  • Insurance procedures
  • Billing Procedures
  • Provider Relations
  • Understanding of medical terms

Timeline

Insurance Verification/Prior Authorization Specialist

Kelsey-Seybold
08.2023 - 03.2024

Insurance Verification Coordinator

USPI- United Surgical Partners International
03.2023 - 08.2023

Insurance Verification Representative

Boston Scientific
03.2022 - 01.2023

Rural Mail Carrier Associate/Seasonal Worker

USPS
11.2021 - 02.2022

Warehouse Operator

Medline
02.2018 - 05.2020

Some College (No Degree) - Medical Business Office Professional

Houston Community College

Similar Profiles

CREATE PROFILE
Ebony Hunter