Prior Authorization Specialist
2 Years 9 MonthsGastroenterology Associates of Tidewater | 01.2024 - Current
- Facilitated prior authorizations for a variety of over 30 medications, including biologics.
- Scheduling infusions
- Oversaw lab monitoring for patients during treatment and coordinated lab order facilitation through EMR.
- Assist patient with enrollment in any patient assistance programs applicable for financial hardships related to treatment.
- Handled insurance billing claims efficiently.
- Utilized Cover My Meds platform to assist patients.
- ICD 10 Codes, CPT Codes
- 20 years of medical Terminology
- Utilized EClinicalWorks software for electronic health records management.
- Verified patient insurance eligibility, facilitating access to treatments and services for patients.
- Epic
- All insurance log ins
- Submitted Appeals for denials
- End to end start to finish
- Tracked authorization statuses, follow-ups, and denial responses to maintain accurate workflow continuity.
Medical Prior Authorizqatiions
3 MonthsCapital Digestive Care | 06.2026 - 09.2026
- Managed time and resources to ensure timely completion of prior authorization requests.
- Adjusted to changing priorities to maintain workflow in fast-paced environment.
- Collaborated with team and worked independently to meet project deadlines.
- Insurance verifications
- Appeals
- Exhibited personal responsibility in managing time and resources effectively.
- Adapted quickly to changing priorities in a dynamic workplace.
- Balanced teamwork and independent work to achieve project goals.
- Proven ability to learn quickly and adapt to new situations.
- Worked effectively in fast-paced environments.
- Self-motivated, with a strong sense of personal responsibility.
- Excellent communication skills, both verbal and written.
- Insurance Verification
Medical Records Specialist
8 Years 3 MonthsGastroenterology Associates of Tidewater | 10.2015 - 01.2024
- Managed daily operations
- Maintained patient records
- Pulled medical records from hospitals to ensure timely access for patient care
- Verified accuracy of paperwork in each chart to maintain compliance and support effective treatment
- Tracking lab, images as per doctors request.
- Obtained medical records for patients to facilitate continuity of care and support healthcare provider needs.
- Medical record releases
- Produced copies and scanned documents
- Accuracy for HIPAA Compliance
- Scheduling appointments.
- Check in patients
- Collect copay
- Prep charts for procedures
- Confirm appointments
- Insurance Verification
- Referrals for visits and procedures
- Utilized EClinical software for record management
- Operated E ClinicalWorks for scheduling
Customer service
1 Year 5 MonthsSentara | 07.2015 - 12.2016
- Verified insurance details to ensure accurate patient billing and coverage.
- Registered patients efficiently, capturing essential information for streamlined admissions.
- Checked in patients promptly, facilitating a smooth transition to care services.
- Collected copayments from patients during check-in.
- Admissions
- Ensured accurate patient information was recorded during registration.
- Epic Software and HBOC
Patient Relations Specialist
2 Years 1 MonthPariser Dermatology | 09.2013 - 10.2015
- Summary of Qualifications
- Provided customer service support
- Handled phone communications efficiently
- Coordinated patient appointments to optimize scheduling efficiency and enhance patient access to care
- Facilitated new patient registrations
- Performed insurance verification tasks
- Customer service
- Logged incoming medications accurately
- AllScripts Software