Jewell Friedline
Columbia,MO
Summary
Knowledgeable Desired Position with proven track record in managing authorization processes and ensuring compliance with industry standards. Adept at coordinating with team members and healthcare providers, leading to streamlined operations and improved patient satisfaction. Demonstrated expertise in problem-solving and attention to detail, ensuring timely and accurate processing of authorizations.
Overview
31
31
years of professional experience
Work History
Authorization Specialist
Boone Hospital Center
07.2023 - Current
Grievances And Appeals Lead
Elevance Blue Cross and Blue Shield
06.2022 - 05.2023
- Supported my team, Educated team on audits, new policies and procedures
- Review and research any questions regarding my teams cases for other departments
- Insure team completes there cases timely
- Help correct and procedure or policies that are vague or incomplete
- Help my team be successful
- Trained analysts on how to complete a case from beginning to end
Grievances And Appeals Analyst Senior
Anthem Blue Cross and Blue Shield
04.2017 - 06.2022
- Reviewed member's and providers pharmacy appeals
- Ensured the cases were done timely and accurate
- Ensured they were reviewed by our MDs in the correct specialty
- Also worked cases on the medical side for Wisconsin (had the whole state by myself), Missouri second level, and Georgia
- Also was the subject expert that helped to create a training module for Nevada Grievances and Appeals
Customer Service Representative
Anthem Blue Cross Blue Shield
06.2013 - 04.2017
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions
- Remained calm and professional in stressful circumstances and effectively diffused tense situations
- Was a tier 2 rep so handled mainly irate calls
Customer Service Representative
Swiss Colony
01.2008 - 09.2009
Customer Service Representative
Brown Shoe Company
04.2004 - 11.2007
Sales Clerk
Jacks
03.2000 - 07.2003
Drive Thru
Hardees
01.1998 - 06.1998
Waitress, Server, Cashier
Olivers
05.1994 - 01.1995
Education
Associates Degree - Healthcare Admin And Medical Records
University of Phoenix
Tempe, AZ01.2010
Skills
- Proficient in Windows
- Microsoft Teams
- Microsoft Word
- Excel
- PowerPoint
- Critical Thinking
- Meditech
- Workday
- 5 Nine
- Insurance portals for most all insurance companies
- Organizational Skills
- Researching and Analyzing Information
- Handling Multiple Tasks
- Leading a Team
- Good Work Ethic
- Relationship Building
- Team Building
Timeline
Authorization Specialist
Boone Hospital Center
07.2023 - Current
Grievances And Appeals Lead
Elevance Blue Cross and Blue Shield
06.2022 - 05.2023
Grievances And Appeals Analyst Senior
Anthem Blue Cross and Blue Shield
04.2017 - 06.2022
Customer Service Representative
Anthem Blue Cross Blue Shield
06.2013 - 04.2017
Customer Service Representative
Swiss Colony
01.2008 - 09.2009
Customer Service Representative
Brown Shoe Company
04.2004 - 11.2007
Sales Clerk
Jacks
03.2000 - 07.2003
Drive Thru
Hardees
01.1998 - 06.1998
Waitress, Server, Cashier
Olivers
05.1994 - 01.1995
Associates Degree - Healthcare Admin And Medical Records
University of Phoenix