Jada Cortez
Thibodaux,LA
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
5
5
years of professional experience
Work History
Prior Authorization Specialist
Cardiovascular Institute of the South
Houma, LA
08.2022 - Current
- Facilitated communication between providers, payers and health plans regarding prior authorization processes.
- Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
- Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.
- Maintained positive working relationship with fellow staff and management.
- Notified ordering providers of denied authorizations.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Maintained accurate records of all authorization activities in the database system.
- Completed day-to-day duties accurately and efficiently.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
Medical Assistant
Thibodaux Regional Health Systems
Thibodaux, LA
05.2019 - 01.2022
- Assisted with pre-operative preparation of patients including providing instruction about post-operative care plans.
- Educated patients about medications, procedures and physician's instructions.
- Monitored vital signs of hospitalized patients throughout their stay at the hospital or clinic setting.
- Communicated with pharmacies for prescription refills on behalf of supervising physician.
- Documented notes during patient visits.
- Oversaw patient registration, insurance verification, form completion and appointment scheduling to maintain operational efficiency.
- Conducted insurance verification and pre-certification and pre-authorization functions.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Educated patients on healthcare topics such as nutrition and disease prevention methods.
- Maintained accurate medical records through filing, charting, transcription and data entry into electronic health record system.
- Administered injections, medications and treatments as directed by the physician.
Education
Certificate Of Completion - Medical Assisting
Blue Cliff - Houma
Houma, LA05-2019
Skills
- Understanding of Medical Terms
- Pharmacology
- Medical Terminology
- Insurance Information Oversight
- Insurance Procedures
- Effective Communication Skills
- Precertification Requirements
Timeline
Prior Authorization Specialist
Cardiovascular Institute of the South
08.2022 - Current
Medical Assistant
Thibodaux Regional Health Systems
05.2019 - 01.2022
Certificate Of Completion - Medical Assisting
Blue Cliff - Houma
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