Kelecia Lee
Louisville,Ky
Summary
Dedicated patient representative with a positive personality and unique skill set seeking to enhance patients' lives and improve their overall dental experiences. Experienced in providing superior support by offering reliable information on insurance coverage, finance options, and documentation requirements. Proficient in scheduling and database management, ensuring streamlined communication and reduced correspondence backlogs. Adept at identifying client needs and concerns to enhance engagement strategies and deliver exceptional service.
Overview
13
13
years of professional experience
Work History
Janitorial Supervisor
Queens Cleaning
09.2022 - Current
- Assessed facility needs, recommending appropriate cleaning solutions and methods for optimal results.
- Trained staff on safe operation of cleaning equipment, tools, devices and chemical and cleaning agents to efficiently perform duties and reduce harm to floors, fixtures, staff and environment.
- Developed efficient work schedules for janitorial staff to maximize productivity and maintain high standards of cleanliness.
- Issued assignments to staff and inspected special requests and areas of concentration to encourage smooth flow of housekeeping operation.
Prior Authorization Specialist
University of Louisville
05.2024 - 09.2024
- 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.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Researched denied claims and contacted insurance companies to resolve these issues.
PATIENT ACCESS REPRESENTATIVE
Advanced ENT Allergy
12.2020 - 12.2023
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment
- Prior authorization, assists patients who need treatment requiring insurance carrier pre-authorization
- They interview patients to assess their medication needs and liaise with insurance companies and nurse managers for prior authorization approval
- Worked with multiple departments to check proper billing information.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
DENTAL ASSISTANT
University of Louisville College of Dentistry
04.2015 - 11.2015
- Assisting in Graduate Prosthodontics Department
- Assist the doctor with patient's
- Schedule appts
- Strengthened client relationships through effective communication regarding billing issues and concerns.
- Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.
CUSTOMER SERVICE REPRESENTATIVE
Gannett
01.2012 - 05.2013
- Assisted customers with on-line access
- Account adjustments
- Payment Management and handled Customer Issues
- Took 80 calls daily
- Floor walked for teammates who needed assistance
Education
HIGH SCHOOL DIPLOMA -
Liberty Christian Academy
Louisville KyEDDA -
MedQuest College
Louisville, Ky04.2015
Skills
- Calm and Effective Under Pressure
- Caring and Empathetic
- Explaining Policy and Procedures
- Knowledge of Community Services and Programs
- Patient Needs Assessment and Referral
Timeline
Prior Authorization Specialist
University of Louisville
05.2024 - 09.2024
Janitorial Supervisor
Queens Cleaning
09.2022 - Current
PATIENT ACCESS REPRESENTATIVE
Advanced ENT Allergy
12.2020 - 12.2023
DENTAL ASSISTANT
University of Louisville College of Dentistry
04.2015 - 11.2015
CUSTOMER SERVICE REPRESENTATIVE
Gannett
01.2012 - 05.2013
HIGH SCHOOL DIPLOMA -
Liberty Christian Academy
EDDA -
MedQuest College
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