Summary
Overview
Work History
Education
Skills
Timeline
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IRIS CORLEY

Remote Worker Customer Service
Jackson,Mississippi

Summary

Detail-oriented professional with excellent communication, interpersonal, and creative thinking skills. Aiming to leverage my abilities to successfully fill the vacancy at your company. Frequently praised as hard-working by my peers, I can be relied upon to help your company achieve its goals.

Overview

6
6
years of professional experience

Work History

Prior Authorization Specialist-temp

Shfyoff
08.2024 - 01.2025
  • Maintained up-to-date knowledge of insurance policies and procedures related to prior authorization requirements.
  • I reviewed the medical records thoroughly before submitting them for the pre-authorization review process.
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Investigated 250 claimants for possibility of fraud and abuse
  • Checked with employers and other references to verify answers, and obtained further information.
  • Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
  • Interpreted and explained information such as eligibility requirements, application details, payment methods, and applicants' legal rights.
  • Coordinated with pharmacy staff to ensure timely dispensing of medications following authorization approval.

Data Entry Clerk / Appointment Scheduler

Shiftsmart
11.2023 - 08.2024
  • Transfer data from the computer and da.
  • Organized, sorted, and checked input data against original documents.
  • Sorted documents and maintained organized filing process.
  • Verified accuracy of data entered into system to produce error-free reports.
  • Review and correct the data for accuracy.
  • Improved database integrity by regularly updating records to ensure relevancy and accuracy of information.
  • Reduced turnaround time for projects by consistently meeting or exceeding deadlines while maintaining high-quality work output.
  • Examined written sources to obtain and review data quality.8
  • Made average of 100 outbound and inbound calls per day.

Outbound Remote Worker- Temp

Kelly Services
02.2022 - 08.2023
  • Conducted regular reviews of operations and identified areas for improvement.
  • Educated customers on offerings and upsold products and services to increase revenue.
  • Contacted customers after sales process to drive ongoing customer satisfaction and resolve issues and complaints.
  • Reduced call handling time by efficiently navigating through customer databases and CRM systems.
  • Maintained productive, efficient approach to all tasks.
  • Followed-up on leads produced by 80 outbound marketing campaigns based on established criteria.
  • Monitored and verified merchandise for proper prices and labels.
  • Conducted follow-up calls to gauge customer satisfaction levels and identify opportunities for upselling or cross-selling services.
  • Worked fast to complete tasks and meet daily deadlines.

Remote Claims Representative-Temp

Direct Interactions
07.2022 - 11.2022
  • Streamlined data entry processes, improving efficiency in claim file management.
  • Collaborated with legal teams to defend against unjustified claims, protecting company assets.
  • Reviewed and updated claim processing guidelines, ensuring alignment with industry standards.
  • Implemented customer feedback system to identify areas for improvement in claims process.
  • Investigated and resolved 100 complex claims, ensuring adherence to policy guidelines and regulatory compliance.
  • Reduced claim resolution times with thorough documentation and timely follow-up.
  • Coordinated with healthcare providers to verify treatment plans and expenses.
  • Modified, updated and processed existing policies.

Remote Customer Service/Healthcare Rep

Lincare
09.2018 - 06.2021
  • Navigate the plan benefits.
  • Educated patients on disease prevention and self-care management for improved health outcomes.
  • Conducted regular 200 audits of medical records to ensure accuracy and completeness, resulting in improved patient care.
  • Assisted in the implementation of new electronic health record systems, boosting efficiency within the organization.
  • Talk to providers about policies and producers.
  • Increased access to healthcare services by assisting with insurance verification and pre-authorization processes.
  • Improved patient satisfaction by efficiently addressing concerns and providing exceptional customer service.
  • Delivered high-quality patient education materials to enhance understanding of treatment options and promote informed decision making.

Education

GED - English

Jackson State University
Jackson, Mississippi
03.2019

Skills

  • Insurance verification
  • Insurance procedures
  • Patient scheduling
  • Provider relations
  • Medical terminology
  • Billing procedures
  • Authorizations
  • Healthcare regulations
  • Remote Enrollment Specialist
  • Prescription coordination
  • Medical office procedures
  • Records maintenance
  • HIPAA compliance
  • CPT coding
  • Utilization review experience
  • Electronic health records proficiency
  • Claim research
  • Retro-authorizations
  • Claims processing experience
  • Customer service
  • Payment collection
  • Fraud detection

Timeline

Prior Authorization Specialist-temp

Shfyoff
08.2024 - 01.2025

Data Entry Clerk / Appointment Scheduler

Shiftsmart
11.2023 - 08.2024

Remote Claims Representative-Temp

Direct Interactions
07.2022 - 11.2022

Outbound Remote Worker- Temp

Kelly Services
02.2022 - 08.2023

Remote Customer Service/Healthcare Rep

Lincare
09.2018 - 06.2021

GED - English

Jackson State University

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