IRIS CORLEY
Jackson,Mississippi
Summary
Developed excellent communication and problem-solving skills in healthcare environment, focusing on patient interactions and information management. Skilled in handling inquiries, resolving issues, and ensuring patient satisfaction. Seeking to transition into new field, leveraging these transferable skills to make meaningful impact.
Overview
3
3
years of professional experience
Work History
PRIOR AUTHORIZATION SPECIALIST
08.2024 - 01.2025
- Maintained up-to-date knowledge of insurance policies and procedures related to prior authorization requirements
- Reviewed medical records thoroughly before submitting them for preauthorization review process
- Managed incoming calls from providers regarding status updates of pending authorizations
- Assessed applicants' eligibility for various government programs
- Investigated claimants for possibility of fraud and abuse
- Checked with employers and other references to verify answers and obtained further information
- Interpreted and explained information such as eligibility requirements, application details, payment methods, and applicants' legal rights.
DATA ENTRY CLERK
Shiftsmart
11.2023 - 08.2024
- Transfer data from computer and database.
- Organize spreadsheet.
- Update weekly reports.
- Review and correct data for accuracy.
- Examined written sources to obtain and review data quality.
OUTBOUND REMOTE WORKER
Kelly Services
02.2022 - 08.2023
- Outbound call
- Referred complex cases requiring further attention and follow-up to appropriate personnel.
- Recorded customer interactions using company's Customer Relationship Management (CRM) system.
- Answered clients' questions and presented product value propositions to promote purchases.
REMOTE CLAIMS REPRESENTATIVE
Direct Interactions
07.2022 - 11.2022
- Adjust claims.
- Processed and analyzed customer claims with accuracy and attention to detail
- Maintained accurate records of all communications with customers
- Utilized effective problem-solving techniques to resolve complex customer issues
- Maintained accurate and up-to-date records of claims processing activities
- Processed and adjudicated medical claims according to health plan polices
- Compiled data from multiple sources for reporting purposes
- Maintained detailed records of all claim activities including notes about.
Education
GED - English
Jackson State University
Jackson, MississippiSkills
- HIPAA compliance Patient
- Insurance verification
- Medical terminology Billing procedures
- Authorizations Healthcare regulations
- Insurance procedures Patient scheduling
- Provider relations
- Outbound Calling
- Claims Processor
- CRM
- Customer Service Rep
- Property adjusting
- Case documentation
Timeline
PRIOR AUTHORIZATION SPECIALIST
08.2024 - 01.2025
DATA ENTRY CLERK
Shiftsmart
11.2023 - 08.2024
REMOTE CLAIMS REPRESENTATIVE
Direct Interactions
07.2022 - 11.2022
OUTBOUND REMOTE WORKER
Kelly Services
02.2022 - 08.2023
GED - English
Jackson State University
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