Summary
Overview
Work History
Education
Skills
Timeline
Generic

Juanita Mann

Lake Charles,LA

Summary

An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth. Highly motivated employee with a desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Skilled team member with an understanding of medical office standards and compliance requirements. Experienced in customer service and inner-office operations. Hardworking, reliable precertification specialist with strong multitasking abilities. Highly organized, proactive, and punctual, with a team-oriented mentality. Specialized in radiology imaging authorizations, with additional knowledge in nuclear medicine, Oncology, and nerve conduction studies.

Overview

17
17
years of professional experience

Work History

Utilization Review Coordinator

Quorum Health
Brentwood, Tennessee
03.2025 - 08.2025
  • I worked on daily discharge and hospital census reports.
  • Faxed all pertinent clinical information to insurance payors regarding the authorization request.
  • Followed up daily by phone or portal to check the status of the request.
  • Updated patient accounts with approvals or denials.
  • Entered denials in the tracker and forwarded them to the nurses and Pac team.
  • Assisted with appeals processes related to denied claims or requests for additional information from payers.
  • Communicated authorization decisions to providers and patients in a timely manner.
  • Documented all utilization review activities, findings, and decisions in patient records and databases.

Utilization Review Coordinator

Steward Health
Dallas, Texas
11.2023 - 03.2025
  • I worked on daily discharge and hospital census reports.
  • Faxed all pertinent clinical information to insurance payers regarding the authorization request.
  • Followed up daily by phone or portal to check the status of the request.
  • Updated patient accounts with approvals or denials.
  • Entered denials in the tracker and forwarded them to the nurses and Pac team.
  • Coordinated with insurance companies to resolve authorization issues and delays.
  • Maintained accurate records of authorization statuses in electronic health systems.
  • Updated spreadsheets and other document filing systems.

Precertification Specialist

Center for Orthopaedics & Spine, LLC
Lake Charles, LA
03.2008 - 03.2024
  • Efficiently perform insurance verification for pre-certification and pre-authorization functions.
  • Some communication with patients by phone to verify and obtain additional information.
  • Calls with insurance companies to obtain benefits information for patients.
  • Updates to patient and insurance data and input changes into company computer system.
  • Retain medical terminology understanding in an effort to better comprehend procedures.
  • Perform verification of Medicare coverage.
  • Adhere to HIPAA requirements to safeguard patient confidentiality.
  • Assist patients if needed to complete paperwork to obtain prior authorizations for procedures.
  • Communicated with insurance companies to facilitate precertification approvals.
  • Maintained organized records of all precertification communications and documentation.
  • Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
  • Collaborated with other departments within the organization as needed to resolve issues or obtain additional information.
  • Compiled and submitted precertification requests for review by payers in accordance with established timelines.
  • Utilized various software applications such as electronic medical record systems for data entry purposes.
  • Processed appeals when necessary following denial or rejection of claims due to lack of proper authorization.
  • Ensured compliance with all HIPAA regulations pertaining to protected health information.
  • Adhered to HIPAA requirements to safeguard patient confidentiality.
  • Answered telephones and directed calls to appropriate medical or administrative staff.
  • Transmitted medical records and other correspondence by mail, e-mail, or fax.

Precertification Specialist

Imperial Health
Lake Charles, Louisiana
03.2008 - 02.2020
  • Communicated with insurance companies to facilitate precertification approvals.
  • Coordinated with medical staff to gather necessary documentation for procedures.
  • Maintained organized records of all precertification communications and documentation.
  • Collaborated with other departments within the organization as needed to resolve issues or obtain additional information.
  • Compiled and submitted precertification requests for review by payers in accordance with established timelines.
  • Maintained detailed documentation of all activities related to the precertification process.
  • Utilized various software applications such as electronic medical record systems for data entry purposes.
  • Processed appeals when necessary following denial or rejection of claims due to lack of proper authorization.
  • Ensured compliance with all HIPAA regulations pertaining to protected health information.
  • Resolved any discrepancies identified during the precertification process.
  • Explained reasons behind application denials and recommended further action.
  • Communicated with patients with compassion while keeping medical information private.
  • Adhered to HIPAA requirements to safeguard patient confidentiality.
  • Transmitted medical records and other correspondence by mail, e-mail, or fax.

Education

Medical Office Assistant - Medical

Delta School of Business And Technology
Lake Charles, LA
03.2008

High School Diploma -

Calcasieu Pm High School
Lake Charles, LA
05.1992

Lagrange High School
Lake Charles, LA

Skills

  • Knowledgeable in Word, Excel
  • Telephone Etiquette
  • Verbal and Written Communication
  • Detail-Oriented
  • Customer Service
  • Outpatient Procedures
  • HIPAA Compliance
  • Insurance Authorizations
  • Computer Proficiency
  • Organization and Time Management
  • Insurance verification
  • Attention to detail
  • Time management
  • Team collaboration
  • Prior authorization
  • Patient satisfaction

Timeline

Utilization Review Coordinator

Quorum Health
03.2025 - 08.2025

Utilization Review Coordinator

Steward Health
11.2023 - 03.2025

Precertification Specialist

Center for Orthopaedics & Spine, LLC
03.2008 - 03.2024

Precertification Specialist

Imperial Health
03.2008 - 02.2020

Medical Office Assistant - Medical

Delta School of Business And Technology

High School Diploma -

Calcasieu Pm High School

Lagrange High School

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