Kasey Fischer
Beaver Dam,WI
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 4 years of managing documentation. Considered team player with exemplary multitasking skills.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Health Insurance Verification Specialist
Atos Medical Inc.
12.2023 - Current
- Act as an advocate for our customers in relation to insurance benefit verification.
- Obtain and secure authorization, or pre-certifications required for patients to acquire Atos Medical products.
- Verifies the accuracy and completeness of patient account information.
- Inquire about gap exception waiver from out of network insurance payers.
- Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for customers. Follows up with physician offices, customers and third-party payers to complete the pre-certification process.
- Obtaining single case agreements when requesting an initial authorization with out of network providers. This process may entail the negotiation of pricing and fees and will require knowledge of internal fee schedules, out of network benefits, and claims information.
- Requests medical documentation from providers not limited to nurse case reviewers and clinical staff to build on claims for medical necessity.
- 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.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
Client Service Representative III
J.J. Keller & Associates
07.2021 - 09.2023
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Introduced clients to available online resources and services to increase convenience.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Responded proactively and positively to rapid change.
- Built sustainable client relationships built on trust by applying excellent communication and interpersonal skills.
- Delivered high level of service to clients to both maintain and extend relationships for future business opportunities.
- Documented customer correspondence in CRM to track requests, problems and solutions.
- Learned and maintained in-depth understanding of product information, providing knowledgeable responses to diverse questions
- Managed over 150 calls, emails, and chats weekly.
DRP Centralized Support
American Family Insurance
08.2016 - 05.2021
- Planned and conducted investigations of claims to confirm coverage and compensability.
- Resolved claims by approving or denying documentation, calculating benefits due and determining compensation settlement.
- Documented specific claims by completing and recording forms, reports and logs.
- Drafted statements of loss to summarize damages, payments and underlying policy coverages.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Collaborated with fellow team members to manage large volume of claims.
Policy Sales & Service Representative
American Family Insurance
03.2012 - 08.2016
- Maintained high standards of customer service by building relationships with clients.
- Responded to customer calls swiftly to resolve issues and answer questions.
- Determined client needs and financial situations by listening and scheduling fact-finding appointments.
- Spent ample time with each customer, verbally reviewing and explaining documents for client comprehension.
- Worked to accommodate new and different insurance requests and explored new value opportunities to optimize insurance agency reputation.
- Displayed consistent, positive attitude towards customers, peers and other personnel, even during high-stress situations.
- Calculated premiums and established payment methods for sales.
- Handled 50 calls, emails, and chats per day to address customer inquiries and concerns
Education
AAPC - Medical Billing & Coding
Moraine Park Technical College
Fond Du Lac, WI12.2025
High School Diploma -
Beaver Dam High School
Beaver Dam, WI06.2006
Skills
- Expert Problem Solving
- Documentation Management
- ICD-10 Coding Familiarity
- Medical Terminology
- Medical Appeals Handling
- Insurance Verification
- Authorizations
- Effective communication skills
- Proficient in Microsoft programs, Brightree, Epic, SAP
Certification
SQL Developer, Coursera - 2023
Timeline
Health Insurance Verification Specialist
Atos Medical Inc.
12.2023 - Current
Client Service Representative III
J.J. Keller & Associates
07.2021 - 09.2023
DRP Centralized Support
American Family Insurance
08.2016 - 05.2021
Policy Sales & Service Representative
American Family Insurance
03.2012 - 08.2016
AAPC - Medical Billing & Coding
Moraine Park Technical College
High School Diploma -
Beaver Dam High School
SQL Developer, Coursera - 2023
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