Jasmine Ingram
Louisville,KY
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. I have the willingness to take on added responsibilities to meet team goals. I am a detail-oriented team player with strong organizational skills. I have the ability to handle multiple projects simultaneously with a high degree of accuracy. I am seeking to maintain a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
11
11
years of professional experience
Work History
Prior Authorization Specialist
Commonwealth Pain Associates
Louisville, KY
11.2021 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
Case Manager/BI PA Specialist
Pharamacord-Louisville, KY
Louisville, KY
05.2019 - 11.2021
- I was a part of the launch for the Akebia Team where I took on the role and responsibility of front facing Case Manager for the Northeast Region
- In my role, I worked directly with the client, sales reps, and facilities in assisting patients with obtaining drug coverage for medication
- Answering calls, responding to emails, verifying drug coverage, PAP assistance, refills and assisting with the prior authorization process are my job duties
- I later transitioned to the sole role of BI/PA specialist due to business needs where I now assist in the Mid-South Region
- I work directly with the front facing Case Manager in locating and verifying coverage for patients and assisting in the initiation of the Prior Authorizations along with follow ups on the status of submitted prior authorizations.
Medical Billing Specialist
Onco360
Louisville, KY
05.2018 - 05.2019
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Located errors and promptly refiled rejected claims.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Liaised between patients, insurance companies, and billing office.
Sandoz- Case Manager III
RxCrossroads By McKesson
Louisville, KY
02.2013 - 05.2018
- Verifying benefits through insurance companies for Glatopa, a medication used for the treatment of the diagnosis of Multiple Sclerosis.
- Triage prescription to pharmacies to be shipped to patient once we had determined drug coverage.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
Case Manager
RxCrossroads By McKesson
Louisville, KY
02.2013 - 05.2018
- Front facing case manager for the Northeast Territory which includes assisting patients and nephrology offices in Delaware, Maryland, New Jersey, Pennsylvania, and Virginia
- Assisting doctor's offices with enrolling their patients in the Veltassa Konnect program where we provide medication to patients with a diagnosis of hyperkalemia
- Verified benefits for drug coverage, initiating and following up on prior authorizations/appeals, and contacting the patients to discuss summary of benefits.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
Education
Nursing
Galen College of Nursing
Louisville, KY10.2014
Skills
- Billing
- Typing 60 wpm
- Case management
- Excel
- Microsoft office
- Powerpoint
- Word
- Prior Authorization Process
- Medical Terminology
- Medical Appeals Handling
- Insurance Verification
- Authorizations
- Medicare and Medicaid knowledge
- Data Entry
- HIPAA Compliance Knowledge
- ICD-10 Coding Familiarity
- Medical terminology knowledge
- Benefit Coverage
Timeline
Prior Authorization Specialist
Commonwealth Pain Associates
11.2021 - Current
Case Manager/BI PA Specialist
Pharamacord-Louisville, KY
05.2019 - 11.2021
Medical Billing Specialist
Onco360
05.2018 - 05.2019
Sandoz- Case Manager III
RxCrossroads By McKesson
02.2013 - 05.2018
Case Manager
RxCrossroads By McKesson
02.2013 - 05.2018
Nursing
Galen College of Nursing