Jasmine Anthony
Lancaster,SC
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
4
4
years of professional experience
Work History
Medical Billing Specialist
Carolina Heart Specialists
09.2023 - Current
- Researched new insurance policies
- Prepped hospital sheets
- Reviewed patients' medical information
- Post hospital charges
- Answered questions about billing and took payments over the phone
- Prepare and submit billing data and medical claims to insurance companies
- Ensuring each patient’s medical information is accurate and up to date
- Systems used EHR, Nextgen, Etenet ( PMC ), Availity and Waystar
- Generate revenue by making payment arrangements, collecting accounts and monitoring and pursuing delinquent accounts
Prior Authorization Representative
CVS Health
10.2021 - 09.2023
- Utilized multiple software systems to complete Medicare appeals case reviews
- Complied with turnaround time, productivity, and quality standards
- Conveyed resolution to provider via direct communication and professional correspondence
- Acquired and maintained basic knowledge of relevant and changing Med D guidelines
- Completed the pre-authorization process through the computer system by reviewing faxes received for prescription medications, completing the authorization, and sending out notifications to the patient and the prescriber
- Received, processed, and ensured document classification was completed and transmitted to clients
- Handled outbound correspondence from the client to be processed
- Received documents from both electronic and hard copy forms
- Transferred data from hard copies to digital databases, organizing information in new formats
- Maintained database by entering new and updated customer and account information
- Systems used were RX Claim, CRM
Customer Support Specialist
Everise, Humana
09.2020 - 10.2021
- Verified benefits
- Handled inbound calls regarding updating demographics, pharmacy refills, Medicare policy information
- Updated & located Primary Care Physicians
- Escalated customer concerns, issues, and requirements to supervisors for immediate rectification
- Exceeded company productivity standards on a consistent basis
- Handled escalated support cases with diplomacy and tact, successfully defusing tense situations between the company and its customers
Education
High School Diploma -
Lancaster High School
Lancaster, SC 05.2001 -
Skills
Medical Records
Customer Service
Billing
Data Entry
Collections
Database management
Insurance verification
Prior Authorization
Timeline
Medical Billing Specialist
Carolina Heart Specialists
09.2023 - Current
Prior Authorization Representative
CVS Health
10.2021 - 09.2023
Customer Support Specialist
Everise, Humana
09.2020 - 10.2021
High School Diploma -
Lancaster High School
05.2001 -
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