Gerri Beys
Hillsboro,IL
Summary
Dynamic and results-driven professional with extensive experience as a Prior Authorization Specialist at AHS Medical LLC. Proven track record in achieving high success rates in obtaining authorizations through effective communication and meticulous documentation. Skilled in insurance verification and patient relations, demonstrating adaptability and strong organizational abilities in fast-paced environments.
Hardworking Job Title brings top-notch abilities in reception and clerical work. Equipped to handle fast-paced office operations with continuous flow of patients and assignments. Meticulous in completing assignments and always ready to help team members.
Overview
2026
2026
years of professional experience
Work History
Medical Office Receptionist
AHS Medical LLC
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Improved patient satisfaction with timely and accurate processing of prior authorizations for medications and procedures.
- Developed and maintained productive working relationships with healthcare providers.
- Identified trends in denials through data analysis, adapting strategies accordingly for improved success rates in obtaining approvals.
Prior Authorization Specialist
AHS Medical LLC
Granite City, IL
08.2021 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Improved patient satisfaction with timely and accurate processing of prior authorizations for medications and procedures.
- Developed and maintained productive working relationships with healthcare providers.
- Identified trends in denials through data analysis, adapting strategies accordingly for improved success rates in obtaining approvals.
Education
General
Edwardsville Senior High School
Edwardsville, IL05.1981
Skills
- Record preparation
- Front desk operations
- HIPAA compliance
- Patient check-in
- Patient confidentiality
- Healthcare experience
- Customer service background
- Patient scheduling
- Electronic charting
- Managing patient records
- Data entry
- Insurance verification
- Appointment management
- Appointment scheduling
- Medical charting
- Patient relations
- Appointment setting
- Scheduling proficiency
- Medical records management
- Medical coding
- Healthcare coding
- Data entry knowledge
- Patient reception management
- Call handling
- Co-payment collection
- Copayment collection
- Clinical experience
- HIPAA guidelines
- Reminder calls
- Electronic medical records
- Medical terminology
- Documentation
- Payment collection
- Telephone etiquette
- Workflow optimization
- Referral verification
- Petty cash management
- Patient callbacks
- Insurance verifications
- Teamwork
- Teamwork and collaboration
- Customer service
- Multitasking
- Multitasking Abilities
- Adaptable and flexible
- Reliability
- Organizational skills
- Team collaboration
Timeline
Prior Authorization Specialist
AHS Medical LLC
08.2021 - Current
Medical Office Receptionist
AHS Medical LLC
General
Edwardsville Senior High School