Kiara Shields
Houston,TX
Summary
LPN graduate with over seven years of experience performing administrative and clinical tasks in various healthcare environments. Looking to apply my background in managed healthcare to help fulfill any and all clinical needs at your facility.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Insurance Verification Specialist
Premier Medical Resources
Houston , TX
06.2025 - Current
- Obtaining pre-certification and referrals for inpatient and same-day encounters.
- Confirming and satisfying all authorization billing requirements by obtaining the appropriate precertification/authorization from all necessary payers to avoid delays in treatment or payment penalties.
- Verification of benefits and pre-certification of all elective, urgent, and emergency admissions.
- Providing specialized support in the areas of insurance, and billing information.
- Utilizes multiple online resources to initiate and verify the authorization needed for prompt submission.
- Organizes time effectively, minimizing incidental overtime, and sets priorities.
Insurance Verification Representative
Penn Medicine: University of Pennsylvania Health System
Philadelphia , PA
01.2025 - 05.2025
- Verified insurance eligibility for patients using electronic records and databases.
- Processed prior authorization requests through various insurance portals efficiently.
- Adhered to HIPAA guidelines when handling confidential information.
- Collaborated with other departments to ensure timely payment of claims.
- Followed up on pending cases with appropriate parties as needed.
- Entered all pertinent data into computer systems accurately and efficiently.
- Verified patient eligibility and benefits for insurance coverage.
Patient Access Coordinator/Referral Coordinator
Lankenau Medical Center
Wynnewood, Pennsylvania
05.2018 - 01.2023
- Streamlined workflows to improve efficiency in patient intake procedures.
- Collaborated with clinical teams to support seamless patient care transitions.
- Verified insurance eligibility and ensured coverage of services to be provided.
- Assisted in obtaining prior authorizations from insurance companies.
- Processed referrals from primary care physicians and other healthcare providers.
- Audited accounts receivable balances for assigned accounts regularly.
- Researched discrepancies between insurance company information and hospital records.
Education
Certificate - Practical Nursing
Prism Career Institute
06-2021
High School Diploma -
Archbishop Prendergast High School
06-2007
Skills
- Healthcare regulations
- Insurance verification
- Workflow optimization
- Time management
- Problem solving
- Effective communication
- Detail orientation
- Cross-department collaboration
- Customer service
- Vital signs monitoring
- Medication administration
- EPIC EMR software
Certification
- Licensed Practical Nurse, Pennsylvania Board of Nursing, License #PN325627
Education and Training
other,other
Personal Information
Timeline
Insurance Verification Specialist
Premier Medical Resources
06.2025 - Current
Insurance Verification Representative
Penn Medicine: University of Pennsylvania Health System
01.2025 - 05.2025
Patient Access Coordinator/Referral Coordinator
Lankenau Medical Center
05.2018 - 01.2023
Certificate - Practical Nursing
Prism Career Institute
High School Diploma -
Archbishop Prendergast High School
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