Holly Ferrell-Gray
Narrows,VA
Summary
Experienced prior authorization coordinator with expertise in insurance policies, medical terminology, and healthcare systems. Proven skills in coordinating patient care, authorizing procedures, and managing health records. Successfully streamlined processes to enhance efficiency while ensuring compliance with regulatory standards. Significant contributions to team productivity and improved patient satisfaction in previous roles.
Overview
1
1
Certification
13
13
years of professional experience
Work History
Prior Authorization Coordinator & Referral Specialist
Community Health Center of the New River Valley
11.2020 - Current
- Processed prior authorizations for medications, diagnostic imaging, procedures, and specialty services using payer portals, fax systems, and insurance phone systems
- Managed submission and tracking of medication prior authorizations for all three office locations supporting multiple providers and specialties
- Coordinated specialty medication authorizations including Brixadi, Vivitrol, and Sublocade while ensuring timely approvals and continuity of patient care
- Tracked authorization status, coordinated appeals, and facilitated peer-to-peer reviews for denied services to support timely patient care
- Review and compile clinical documentation to support medical necessity and payer requirements
- Verified insurance eligibility, coverage limitations, and benefits to ensure services rendered align with patient needs
- Coordinate referrals to specialty providers and ensure timely transfer of medical records, labs, and imaging results
- Served as liaison among providers, nursing staff, insurance representatives, pharmacies, and patients to streamline communication and mitigate delays in care
Call Center Representative
MTM, Inc.
Pulaski, VA
10.2015 - 03.2019
- Coordinated high-volume inbound calls for non-emergency medical transportation, ensuring efficient service delivery
- Verified member eligibility and accurately documented trip requests within scheduling systems
- Addressed member and provider concerns, upholding professionalism and strict HIPAA compliance
- Escalated complex service issues according to company protocol and documentation standards
- Facilitated onboarding and mentoring for new customer service representatives, enhancing team integration
Personal Care Aide
Human Touch Home Health
10.2013 - 06.2015
- Facilitated clients' daily living activities, enhancing independence in mobility, dressing, bathing, and personal care
- Delivered compassionate support while maintaining a safe, clean environment for clients' comfort and health
- Managed medication reminders and tracked basic health indicators to promote client well-being
- Maintained accurate documentation according to individualized care plans
Education
Pharmacy Technician Program -
US Career Institute
01-2025
Phlebotomy & ECG Technician Certification -
American National University
01-2020
Medical Billing & Coding Diploma -
Ultimate Medical Academy
01-2014
Associate Degree - Healthcare Administration
University of Phoenix
01-2012
Skills
- Prior authorizations
- Referral coordination
- Insurance verification
- Claims Processing
- Medical Necessity Documentation
- DME coordination
- Imaging authorizations
- Care coordination
- Medicare
- Medicaid
- Insurance experience
- EHR documentation
- Epic
- EClinicalWorks
- Availity
- Payer systems
- EHR/EMR Systems
- Microsoft Excel
- HIPAA Compliance
- Medical Terminology
- Healthcare customer service
Certification
- Pharmacy Technician Certification PTCB
- VADHP: Board of Pharmacy
Timeline
Prior Authorization Coordinator & Referral Specialist
Community Health Center of the New River Valley
11.2020 - Current
Call Center Representative
MTM, Inc.
10.2015 - 03.2019
Personal Care Aide
Human Touch Home Health
10.2013 - 06.2015
Pharmacy Technician Program -
US Career Institute
Phlebotomy & ECG Technician Certification -
American National University
Medical Billing & Coding Diploma -
Ultimate Medical Academy
Associate Degree - Healthcare Administration
University of Phoenix