RAINA SWISHER
Shipman,IL
Summary
Dependable Medical Professional experienced in customer service, data entry, and records management. Delivered patient satisfaction through effective management of patient records and accurate collection of payments. Dedicated to ensuring compliance with regulatory standards while fostering trust and rapport with patients in fast-paced healthcare settings.
Overview
1
1
year of post-secondary education
11
11
years of professional experience
Work History
Prior Authorization Specialist
Carlinville Area Hospital
Carlinville, Illinois
12.2025 - Current
- Reviewed patient records for prior authorization requests.
- Communicated with insurance companies regarding coverage and policies.
- Coordinated with healthcare providers to gather necessary documentation.
- Coordinated scheduling for multiple departments to optimize resource allocation.
- Managed appointment systems to ensure efficient time management for staff.
- Assisted in prioritizing appointments based on urgency and availability.
Medical Assistant/Prior Authorization Representative
Community Clinic of Staunton
Staunton, Illinois
06.2025 - 11.2025
- Assisted healthcare providers with patient examinations and procedures.
- Coordinated patient scheduling and appointments to enhance workflow efficiency.
- Answered phones, scheduled appointments and managed patient flow while greeting visitors in a professional manner.
- Handled phone inquiries, scheduled appointments, and ensured smooth patient flow while greeting visitors professionally.
- Scheduled appointments for patients via phone and in person.
- Collected laboratory samples from patients for accurate testing and analysis.
Patient Registrar
Carlinville Area Hospital
Carlinville, USA
06.2019 - 06.2025
- Maintain current knowledge of insurance companies requirements regarding pre-certification processes.
- Updated patient demographic information regularly.
- Received patients, recorded demographic information, and verified insurance for emergency department, laboratory, and radiology to facilitate timely care.
- Collaborated with multiple systems including CPSI, Loyale, RevSpring, Avality, and Allscripts to streamline processes.
- Worked effectively and multitasked under pressure in fast-paced environment, ensuring accuracy of data entry and improving patient flow.
Home Health Aide
Home Instead
Litchfield, USA
01.2019 - 06.2019
- Completed documentation for each visit in compliance with agency policy, ensuring accurate client records.
- Transported clients to doctor's appointments and essential outings, enhancing access to care and community resources.
- Supported client independence by assisting with self-care activities such as walking, eating, toileting, and grooming, promoting overall well-being.
Shift Manager
McDonalds
Jerseyville, USA
10.2017 - 01.2019
- Planned each shift, monitored performance, ensured safety, and communicated with the next Shift Manager for smooth transitions.
- The ability to manage food safety, daily maintenance and cleanliness and exceptional customer service.
- Supervised team members during high-volume shifts to ensure efficient service.
- Managed inventory levels and placed orders to maintain stock availability.
- Trained new employees on company policies and customer service standards.
Housekeeping Attendant
Heritage Health
Carlinville, USA
02.2016 - 10.2017
- Maintained cleanliness of public areas patients rooms through regular dusting, vacuuming, mopping,and sanitizing surfaces.
- Maintained cleanliness of public areas and patient rooms through regular dusting, vacuuming, mopping, and sanitizing surfaces to ensure a safe and welcoming environment.
- Assisted with laundry duties by washing, drying, and folding linens to support operational efficiency and guest satisfaction.
- Utilized appropriate tools including vacuum cleaners, mops, brooms, and brushes to execute thorough cleaning operations effectively.
Education
Medical Coding And Billing
DeVry University
02.2026 - 08.2026
High School Diploma -
Southwestern High School
Piasa, ILSkills
- Authorization Management
- Insurance Verification
- Insurance verification
- Authorization Guidelines
- CPT Coding
- ICD-10 coding
- Billing Compliance
- Referral Management
- Appointment scheduling
- Data Confirmation
- Computer Proficiency
- Medical terminology
- Critical Thinking
Timeline
Medical Coding And Billing
DeVry University
02.2026 - 08.2026
Prior Authorization Specialist
Carlinville Area Hospital
12.2025 - Current
Medical Assistant/Prior Authorization Representative
Community Clinic of Staunton
06.2025 - 11.2025
Patient Registrar
Carlinville Area Hospital
06.2019 - 06.2025
Home Health Aide
Home Instead
01.2019 - 06.2019
Shift Manager
McDonalds
10.2017 - 01.2019
Housekeeping Attendant
Heritage Health
02.2016 - 10.2017
High School Diploma -
Southwestern High School