Gina Wieland
Buckeye,AZ
Summary
Dynamic Authorization Specialist with a proven track record at The CORE Institute, excelling in medical terminology expertise and effective communication. Demonstrated success in improving compliance, streamlining prior authorization processes, and mentoring teams for enhanced productivity. Achieved significant reductions in processing times by leveraging claims management skills and fostering strong insurance relationships.
Overview
17
17
years of professional experience
Work History
Authorization Specialist
The CORE Institute
05.2015 - Current
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Conducted regular audits of authorization records to verify accuracy and adherence to regulatory requirements, minimizing risk of noncompliance.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Developed strong relationships with insurance representatives to expedite approvals and resolve issues promptly.
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
Pre-Reg Supervisor
The Core Institute
05.2015 - Current
- Mentored junior staff members in their career development, sharing knowledge from years of experience in the field.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Evaluated customer needs and feedback to drive product and service improvements.
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Evaluated staff performance and provided coaching to address inefficiencies.
Supervisor of Incoming Referral Dept
Arizona Neurological Institute
11.2007 - 09.2014
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Conducted regular reviews of operations and identified areas for improvement.
- Reduced employee turnover by fostering a positive work environment and providing ongoing feedback to staff members.
Education
06-1996
Skills
- Medical terminology expertise
- Claims management
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
- Medical coding
- Effective communication skills
- Medicaid
- Income verification
- Eligibility procedures
Timeline
Authorization Specialist - The CORE Institute
05.2015 - Current
Pre-Reg Supervisor - The Core Institute
05.2015 - Current
Supervisor of Incoming Referral Dept - Arizona Neurological Institute
11.2007 - 09.2014
Lakewood High School - ,
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