Jody Denman
Bessemer City,NC
Summary
Skilled Prior Authorization Specialist and Registered Medical Assistant with a proven track record at Kintegra Health, adept in the prior authorization process and insurance verification. Demonstrated success in reducing authorization turnaround times and enhancing patient-provider relationships through effective communication. Trained new staff, ensuring high authorization success rates and compliance with HIPAA guidelines.
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
28
28
years of professional experience
Work History
Prior Authorization Specialist
Kintegra Health
03.2021 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Provided training to new staff members on the intricacies of various insurance plans and their specific prior authorization requirements.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
Registered Medical Assistant
Kintegra Health
10.2010 - 03.2021
- Maintained strict confidentiality while handling sensitive patient information in accordance with HIPAA guidelines.
- Completed thorough chart reviews to ensure proper documentation of all pertinent medical information.
- Prepared and administered medications to alleviate patient symptoms.
- Prepared examination rooms with necessary tools and instruments prior to each appointment, enabling smooth transitions between patients.
- Assisted physicians with various medical procedures, ensuring accurate results and timely treatment.
- Taught patients about medications, procedures, and care plan instructions.
- Performed essential administrative tasks such as scheduling appointments, updating records, and coordinating referrals.
- Strengthened patient-provider relationships through compassionate communication and attentive listening skills.
- Explained procedures to patients to reduce anxieties and increase patient cooperation.
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
Registered Medical Assistant
Shelby Women's Care
06.1997 - 10.2010
- Prepared examination rooms with necessary tools and instruments prior to each appointment, enabling smooth transitions between patients.
- Improved patient experience by promptly greeting, preparing, and escorting individuals through their visits.
- Supported diagnostic processes with proficient collection of specimen samples for laboratory testing purposes.
- Collaborated with the healthcare team to create personalized care plans for patients.
- Aided in the prevention of illnesses by administering vaccinations according to established protocols.
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications, and other physician instructions.
Education
Associate of Applied Science - Medical Assisting
Gaston College
DallasSkills
- Prior authorization process
- Medical appeals handling
- Insurance verification
- Effective communication skills
- Medical terminology knowledge
- Benefit coverage
- Patient referrals
- Data entry
- Medical office procedures
- Professionalism and ethics
Timeline
Prior Authorization Specialist
Kintegra Health
03.2021 - Current
Registered Medical Assistant
Kintegra Health
10.2010 - 03.2021
Registered Medical Assistant
Shelby Women's Care
06.1997 - 10.2010
Associate of Applied Science - Medical Assisting
Gaston College
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