JESSICA KEISTER
JUNCTION CITY,USA
Summary
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm. Please consider me.
Overview
12
12
years of professional experience
Work History
APPEALS/PRIOR AUTHORIZATION REPRESENTATIVE
Cigna
06.2021 - Current
- Verified eligibility and compliance with authorization requirements for service providers.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Developed and maintained productive working relationships with healthcare providers.
- Processed new medication and refill requests for authorization.Processed prior authorization requests efficiently, ensuring compliance and significantly reducing approval times.Reviewed complex medical documentation to validate requests, enhancing accuracy in decision-making and decreasing error rates.Educated clients on benefits coverage, leading to increased understanding and satisfaction with service offerings.Maintained comprehensive records of appeals and outcomes, contributing to streamlined reporting and enhanced operational efficiency.
- Remote
MEDICAL RECEPTIONIST
River valley woman's health
Lancaster, Ohio
05.2019 - 06.2021
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Maintained current and accurate medical records for patients.
- Verified insurance and patient demographics to ensure all information in patients charts were up to date.
- Data entry.
Medical Laboratory Technician
Muskingum Valley Health Centers
Zanesville, OH
08.2014 - 05.2019
- Conducted complex laboratory tests to diagnose patient conditions and ensure accurate results.
- Followed safety protocols to maintain safe and secure laboratory environment.
- Assisted in the training of new staff members, ensuring proper knowledge transfer and adherence to safety protocols.
- Maintained confidentiality of all patient information to conform to HIPAA, internal, and other regulatory standards.
- Recorded and maintained accurate data to facilitate tracking of results.
- Collaborated with physicians to provide critical input on clinical decisions, based on test results.
Education
STNA - undefined
The Training center
CERTIFIED PATIENT CARE TECHNICIAN - undefined
The Training center
EKG - undefined
The Training center
PHLEBOTOMY - undefined
The Training center
Skills
- HIPAA compliance
- Benefit coverage
- Authorizations
- Basic medical terminology
- Patient scheduling
- Insurance verification
- Data entry proficiency
- Client service
- Healthcare industry
- Electronic records management
- Prescription coordination
- Patient insurance authorizations
- Effective communication skills
- Critical thinking
- Claim research
- Healthcare regulations
- Billing procedures
- Proficiency in software
- Patient referrals
- Teamwork
- Problem-solving
- Time management
Basic medical terminology
Authorizations
Benefit coverage
HIPAA compliance
Patient scheduling
Insurance verification
Data entry proficiency
Client service
Healthcare industry
Patient insurance authorizations
Effective communication skills
Critical thinking
Data entry
Workflow management
Healthcare regulations
Billing procedures
Knowledgeable in software
Medical terminology knowledge
Patient referrals
Teamwork and collaboration
Customer service
Attention to detail
Problem-solving abilities
Multitasking
Reliability
Excellent communication
Organizational skills
Active listening
Office administration
Timeline
APPEALS/PRIOR AUTHORIZATION REPRESENTATIVE
Cigna
06.2021 - Current
MEDICAL RECEPTIONIST
River valley woman's health
05.2019 - 06.2021
Medical Laboratory Technician
Muskingum Valley Health Centers
08.2014 - 05.2019
STNA - undefined
The Training center
CERTIFIED PATIENT CARE TECHNICIAN - undefined
The Training center
EKG - undefined
The Training center
PHLEBOTOMY - undefined
The Training center