Kendra Hughes
Seneca
Summary
Experienced healthcare operations professional specializing in insurance verification and prior authorization. Coordinates timely requests for medical services, ensures compliance with insurance guidelines, and enhances patient access to treatments. Strong communication and problem-resolution skills support accurate documentation and regulatory adherence.
Overview
16
16
years of professional experience
Work History
Prior Authorization Specialist
Laboratory of America Holdings
Joplin, United States
11.2024 - Current
- Coordinated prior authorization process for medical services by submitting timely requests to insurance providers, ensuring patient access to necessary treatments.
- Processed prior authorization requests for laboratory testing services, facilitating timely access to necessary diagnostics.
- Reviewed medical documentation for compliance with insurance guidelines, ensuring approvals aligned with policy requirements.
- Communicated with healthcare providers on authorization procedures and requirements, streamlining collaboration for patient care.
Remote Authorization Specialist
Teleperformance Augusta
Augusta, GA
10.2015 - 11.2024
- Reviewed patient medical histories and insurance coverage for healthcare service authorization, ensuring compliance with procedures and protocols to support timely care delivery.
- Collaborated with physicians to gather patient information, enhancing communication and facilitating accurate and efficient authorization.
- Managed patient records and billing documentation to maintain data accuracy and integrity, supporting seamless processing of healthcare services.
Sales Representative
Communication Solutions
Joplin, MO
08.2012 - 05.2014
- Expanded customer base through strategic cold calling and networking, effectively addressing client issues.
- Elevated client satisfaction through active listening and tailored solutions, contributing to top-tier customer service ranking.
- Developed strong client relationships to enhance customer loyalty and retention.
- Delivered product presentations highlighting features and benefits to engage potential clients.
- Partnered with marketing team to design and implement targeted sales campaigns and promotions.
Customer Service Call Center Agent
Teleperformance USA (Aegis)
Joplin, MO
11.2010 - 08.2012
- Managed 100 calls per shift, facilitating account registrations, providing information, and promoting products and services.
- Resolved customer complaints through effective communication and problem-solving.
- Resolved customer inquiries and issues, improving customer satisfaction and expediting resolution process.
- Assisted customers with product inquiries and service issues, ensuring timely and accurate support.
- Utilized call center software to log customer interactions and resolutions.
Education
High School Diploma -
Muskogee High School
Muskogee, OK06-2007
Skills
- Eligibility Verification
- Precertification requirements
- Authorization Evaluation
- Insurance Verification
- Claims processing
- Claims oversight
- Claims Investigation
- Authorization Appeals
- Patient Coordination
- Patient Support
- Patient History Review
- Medicaid Knowledge
- Private insurance
- Billing Compliance
- Document compliance
- Healthcare Operations
- Workflow management
- Workflow optimization
- Data Entry
- MS Office
- MS Office
- Attention to detail
- Organizational skills
- Analytical Reasoning
- Problem solving
- Problem Resolution
- Time Management
- Communication
- Team Collaboration
- Stakeholder Engagement
- Relationship management
- Customer Service
- Customer Service
- Workflow management
- Document compliance
- Communication
- Healthcare Operations
Timeline
Prior Authorization Specialist
Laboratory of America Holdings
11.2024 - Current
Remote Authorization Specialist
Teleperformance Augusta
10.2015 - 11.2024
Sales Representative
Communication Solutions
08.2012 - 05.2014
Customer Service Call Center Agent
Teleperformance USA (Aegis)
11.2010 - 08.2012
High School Diploma -
Muskogee High School