Jessica Donella
UPMC Osteopathic Hospital
Lemoyne,PA
4
years of professional experience
Dedicated Certified Clinical Medical Assistant with 7 years of healthcare experience and nearly 20 years in customer service. Expertise in medication prior authorization, managing complex processes and building relationships with healthcare providers and insurance companies. Strong understanding of insurance guidelines and compliance, effectively navigating systems to ensure accurate documentation.
Work History
Remote Prior Authorization Specialist PRN
7 Months- Evaluate prior authorization requests for medical services to ensure compliance with insurance guidelines.
- Coordinate communication between healthcare providers and insurance companies to expedite authorization processes.
- Analyze patient eligibility and benefits to determine coverage for prescribed treatments and medications.
- Analyzed patient eligibility and benefits to determine coverage for prescribed treatments and medications.
- Maintain thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Prepare and submit first-level, second-level, and state level appeals.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Continually update knowledge on industry developments, ensuring adherence to best practices and relevant regulatory changes impacting the prior authorization process.
- Streamline prior authorization processes by implementing efficient tracking systems.
- Assist clients with completion of financial assistant applications and paperwork.
- Complete medication prior authorizations using Epic, CoverMyMeds, PromptPA, and payer-specific portals.
Medical Assistant Senior
10 Months- Assist healthcare providers with patient examinations and procedures, ensuring a smooth workflow.
- Direct patients to exam rooms, field questions, and prepare for physician examinations.
- Assist physicians with in-office procedures such as IUD insertions, Colposcopies, and LEEPs which include preparing the procedure room with surgical equipment, reviewing and collecting consent forms, and ensuring patient and provider safety.
- Perform phlebotomy tasks efficiently while ensuring minimal discomfort for patients during blood collection procedures.
- Process and manage high-volume medication prior authorizations from initiation through final determination.
- Review clinical documentation for accuracy and completeness in support of authorization decisions.
- Track and document authorization outcomes to improve workflow and reporting accuracy.
- Resolve escalated issues related to denied authorizations, ensuring appropriate follow-up actions were taken.
- Successfully overturned numerous insurance denials, including a Pennsylvania Department of Health Coverage Access, Administration and Appeals third-party review.
- Collaborate with providers, pharmacies, insurance representatives, and patients to expedite medication approvals.
Moonlight Phlebotomist Technician PRN
1 Year 9 Months- Conducted venipunctures and capillary punctures in an outpatient and inpatient setting, ensuring patient comfort and safety.
- Maintained accurate records of sample collection and processing procedures to ensure compliance with regulations.
- Collaborated with healthcare teams to streamline blood collection processes and improve turnaround times.
- Maintained accurate records of blood samples and patient information using electronic health record systems.
- Implemented quality control measures to enhance the accuracy of laboratory results.
- Upheld HIPAA compliance through careful management of confidential patient records and lab results.
- Centrifuged blood samples as outlined in clinical protocols.
Medical Assistant Senior
1 Year 11 Months- Assisted healthcare providers with patient examinations and procedures, ensuring a smooth workflow.
- Conducting specialized procedures, including suture removal, wound care, and assisting providers in minor surgeries.
- Performing a broad range of diagnostic testing, including EKGs, point-of-care, and phlebotomy.
- Processing prescription requests and completing prior authorizations in a timely manner including insurance denial appeals when requested.
- Responded to clinical and patient messages, addressing concerns and providing information.
- Performed routine lab tests and managed specimen collection efficiently.
- Trained new staff members on operational procedures, fostering a knowledgeable team environment.
- Performed additional administrative duties to support office efficiency and enhance the patient experience.
Moonlight Patient Care Technician
1 Year 3 Months- Supported Cardiac Telemetry, Neurology, and Emergency Department Units in the UPMC Helpers' Program.
- Responded to call lights promptly, ensuring timely attention to patient needs and enhancing patient satisfaction.
- Conducted EKGs, point-of-care glucose testing, and provided 1:1 patient observation and mobility assistance to support patient recovery.
Ambulatory Clinical Associate
1 Year 2 Months- Assisted clinical teams with patient intake, prepared exam rooms, and maintained patient flow in fast-paced outpatient settings to enhance operational efficiency.
- Collaborated with physicians and nursing staff to ensure efficient care delivery and improve patient experience.
- Collaborated with physicians and nursing staff to ensure timely care delivery and enhance overall patient experience.
- Maintained accurate and up-to-date electronic health records (EHR), ensuring compliance with HIPAA and healthcare regulations.
- Managed patient registration and scheduling to facilitate efficient check-in/check-out processes.
- Performed other administrative duties as needed to support office efficiency and enhance the patient experience.
Education
Basic Life Support/CPR/AED Ceritification
CCMA Certification
Phlebotomy Technician Certification
Psychology First Aid
EMT Specialization Certification
Wilderness First Aid
High School Diploma
Skills
Prescription coordination
Pharmacy benefit management
Patient care
Claims Processing
Documentation Review
Point of Care Testing
Phlebotomy
Medical terminology
Prior authorizations
Critical thinking
Time management
Teamwork
Medication Verification
Timeline
Remote Prior Authorization Specialist PRN
UPMC Silver Springs Family Care
01.2026 - CurrentRead More
Medical Assistant Senior
UPMC Women First OBGYN
10.2025 - CurrentRead More
Moonlight Phlebotomist Technician PRN
UPMC Osteopathic Hospital
11.2024 - CurrentRead More
Medical Assistant Senior
UPMC Outpatient Float Pool
11.2023 - 10.2025Read More
Moonlight Patient Care Technician
UPMC West Shore Hospital
11.2022 - 02.2024Read More
Ambulatory Clinical Associate
UPMC Outpatient Float Pool
09.2022 - 11.2023Read More
Cedar Cliff High School
High School Diploma
Read More
HSI
Wilderness First Aid
Read More
Coursera
EMT Specialization Certification
Read More
Coursera
Psychology First Aid
Read More
UPMC
Basic Life Support/CPR/AED Ceritification
Read More
NHA
CCMA Certification
Read More
Allison
Phlebotomy Technician Certification
Read More