Janay Archie
Jarrell
Summary
Healthcare professional prepared for role with strong background in managing prior authorizations and fostering positive relationships with healthcare providers and insurance companies. Known for collaborative approach and consistently achieving results despite changing needs. Proficient in medical coding, insurance guidelines, and effective communication.
Overview
10
10
years of professional experience
1
1
Certification
Work History
E-Referral Specialist - PART TIME REMOTE
Humana Center Well - Home Health
10.2025 - Current
- Coordinated referrals for home health services to ensure timely patient care
- Managed communication between healthcare providers and patients to facilitate service access
- Developed and maintained referral tracking systems for improved operational efficiency
- Trained new staff on referral processes and system usage to enhance team performance
Remote Insurance Follow-Up Representative/Prior Authorization Specialist
Annuity Health
10.2024 - Current
- Resolved outstanding insurance claims through effective follow-up communications and documentation review.
- Analyzed claim denials to identify trends and implement targeted corrective actions.
- Collaborated with healthcare providers to ensure accurate billing and timely reimbursement processes.
- Streamlined follow-up procedures, enhancing efficiency in claim resolution workflows.
Prior Authorization Specialist
Advanced Pain Care
08.2022 - 09.2024
- Detailed and recorded patient histories in electronic medical records
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Provided guidance to providers regarding the prior authorization process.
- Processed appeals in a timely manner as per policy guidelines.
- Maintained accurate records of all authorization activities in the database system.
- Advised provider offices on proper coding practices that are necessary for successful claim submission.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
Front Desk Agent
PSYCH DIMENSIONS, INC
07.2021 - 08.2022
- Managed front desk operations, ensuring seamless guest check-in and check-out processes.
- Provided exceptional customer service, addressing inquiries and resolving issues promptly.
- Coordinated room assignments and maintained accurate reservation records using hotel management software.
- Trained new front desk staff on standard operating procedures and customer service excellence.
- Implemented process improvements that enhanced operational efficiency and guest satisfaction ratings.
CNA/CMA
Baylor Scott & White Health
03.2016 - 01.2020
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation.
- Maintained accurate, timely flow of information by completing thorough patient records and updating healthcare team on patient status.
- Documented activities and recorded information in EMR system.
- Maintained accurate records of patient care, condition, progress, or problems for review by medical staff.
Education
High School Diploma - Communications
Austin Community College
Round Rock, TXSkills
- Insurance verification
- Data entry proficiency
- Pre-authorizations
- Medical terminology
- Teamwork and collaboration
- Attention to detail
- Multitasking
- Multitasking Abilities
- Critical thinking
- Organizational skills
- Verbal and written communication
- Documentation and recordkeeping
Certification
- CPC-P - Certified Professional Coder-Payer (Will graduate - March 2026)
Timeline
E-Referral Specialist - PART TIME REMOTE
Humana Center Well - Home Health
10.2025 - Current
Remote Insurance Follow-Up Representative/Prior Authorization Specialist
Annuity Health
10.2024 - Current
Prior Authorization Specialist
Advanced Pain Care
08.2022 - 09.2024
Front Desk Agent
PSYCH DIMENSIONS, INC
07.2021 - 08.2022
CNA/CMA
Baylor Scott & White Health
03.2016 - 01.2020
High School Diploma - Communications
Austin Community College