Jocelyn Jones
Indianapolis,IN
Summary
Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Managed Health Services MHS
08.2022 - Current
- Streamlined prior authorization processes by implementing efficient tracking systems.
- Improved patient satisfaction with timely and accurate processing of prior authorizations for medications and procedures.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Enhanced communication between healthcare providers and insurance companies, ensuring prompt resolution of issues related to prior authorizations.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Provided training to new staff members on intricacies of various insurance plans and their specific prior authorization requirements.
- Contributed to high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
Provider Services Representative
UnitedHealth Group
05.2021 - 08.2022
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Streamlined operations by managing high volume of incoming calls for medical providers seeking information or assistance.
- Improved communication between providers and insurance companies, leading to better understanding of policy coverage and claim status.
- Assisted in training of new Provider Services Representatives, ensuring consistent quality service delivery.
- Increased efficiency by accurately entering provider data into company systems and databases.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
Certified Clinical Medical Assistant
Urology Of Indiana
01.2020 - 05.2021
- Enhanced patient care by efficiently performing clinical tasks such as taking vital signs and administering medications.
- Contributed to accurate diagnoses by efficiently collecting and preparing laboratory specimens for analysis.
- Improved patient flow within clinic by effectively managing appointment scheduling and timely rooming of patients.
- Ensured optimal patient experience by maintaining clean, comfortable, and organized treatment environment.
- Facilitated effective communication between patients and healthcare providers with clear explanation of medical procedures and treatment plans.
- Assisted physicians in providing quality care through thorough documentation of medical histories and physical examination results.
- Maintained confidentiality of patient information by adhering to HIPAA guidelines at all times during recordkeeping and communications.
Education
High School Diploma -
Penn Foster Career School
Scranton, PA2018
Medical Assisting
Indiana School of Phlebotomy
Indianapolis, IN2020
Skills
- Critical thinking abilities
- Understanding of medical terms
- Medicare and Medicaid knowledge
- Data Entry
- HIPAA Compliance Knowledge
- CPT coding knowledge
- Proficiency in Various Software Applications
- Multitasking Abilities
- Organizational Skills
- Task Prioritization
- Team Collaboration
- Knowledgeable of Microsoft Office Suite
Certification
- Certified Clinical Medical Assistant
- Certified Nursing Assistant
Timeline
Prior Authorization Specialist
Managed Health Services MHS
08.2022 - Current
Provider Services Representative
UnitedHealth Group
05.2021 - 08.2022
Certified Clinical Medical Assistant
Urology Of Indiana
01.2020 - 05.2021
High School Diploma -
Penn Foster Career School
Medical Assisting
Indiana School of Phlebotomy
- Certified Clinical Medical Assistant
- Certified Nursing Assistant
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