Kili Loper
Travel Nurses Across America
Appleton
8
years of professional experience
Healthcare professional prepared for role with strong background in managing prior authorizations and fostering positive relationships with healthcare providers and insurance companies. Known for collaborative approach and consistently achieving results despite changing needs. Proficient in medical coding, insurance guidelines, and effective communication.Proven sales and customer service expert from Alta Resources, adept in client account management and sales strategy development. Excelled in building lasting customer relationships, boosting sales through strategic consultation, and achieving targets. Skilled in handling complaints with professionalism, ensuring customer satisfaction and retention. Demonstrated ability to exceed service standards, contributing to significant business growth.
Work History
Prior Authorization Specialist
5 Months- Processed prior authorization requests efficiently, ensuring compliance with healthcare regulations.
- Collaborated with medical providers to clarify patient treatment plans and required documentation.
- Utilized electronic medical record systems to track authorizations and streamline workflows.
- Monitored authorization timelines, proactively addressing delays to enhance patient care delivery.
- 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.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
Enrollment and Family Support Specialist
10 Months- Collaborated with multidisciplinary teams to ensure comprehensive care for clients across multiple services.
- Tracked progress of family support initiatives, ensuring adherence to best practices and compliance standards.
- Developed individualized support plans for families, enhancing service delivery and client engagement.
- Coordinated resources and referrals, streamlining access to community services for clients in need.
- Implemented feedback mechanisms from clients, enhancing program responsiveness and service effectiveness.
- Enhanced family well-being by providing comprehensive support services and resources.
- Assisted families in navigating complex social service systems to access needed supports and benefits.
- Participated in ongoing professional development opportunities to stay current on best practices in family support services.
- Established trusting relationships with clients, fostering a supportive environment conducive to growth and change.
Sales Representative
2 Years 8 Months- Engaged in friendly conversation with customer to better uncover individual needs.
- Developed strong rapport with customers and created positive impression of business.
- Stayed current on company offerings and industry trends.
- Contributed to team objectives in fast-paced environment.
- Kept detailed records of daily activities through online customer database.
- Worked with sales team to collaboratively reach targets, consistently meeting or exceeding personal quotas.
- Informed customers of promotions to increase sales productivity and volume.
- Met existing customers to review current services and expand sales opportunities.
- Identified new business opportunities through cold calling, networking, marketing and prospective database leads.
- Built relationships with customers and community to promote long term business growth.
- Fostered lasting relationships with customers through effective communication and quick response, resulting in long-term loyalty and expanded client base.
- Maintained current knowledge of evolving changes in marketplace.
Customer Care Representative
1 Year 2 Months- Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
- Responded to customer needs through competent customer service and prompt problem-solving.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Logged call information and solutions provided into internal database.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Investigated and resolved customer inquiries and complaints quickly.
- Followed up with customers about resolved issues to maintain high standards of customer service.
Restaurant Waiter
1 Year 7 Months- Answered customers' questions, recommended items, and recorded order information.
- Cultivated warm relationships with regular customers.
- Bussed and reset tables to keep dining room and work areas clean.
- Explained menu items and suggested appropriate options for food allergy concerns.
- Shared knowledge of menu items and flavors, enabling customers to make personal decisions based on taste and interest.
- Remained calm and poised when dealing with difficult customers or during busy shifts.
- Helped customers with dietary restrictions, allergies and intolerances obtain safe, delicious food by working closely with kitchen staff on alternatives.
- Maintained order efficiency and accuracy through clear communication with kitchen staff, earning numerous recommendations from satisfied customers.
Education
High School Diploma
Skills
Account Management
Sales Development
Sales consultation
Client Account Management
Customer Retention
Customer Needs Assessment
Account Servicing
Customer Service
Sales closing
Client Service
Sales strategy development
Order Management
Menu Memorization
Handling Complaints
Wine pairing knowledge
Professional Appearance
Prior authorization process
Medical terminology
Medical appeals handling
Insurance verification
Data entry
Physician order verification
Benefit coverage
Professionalism and ethics
Workflow management
Patient scheduling
Knowledgeable in [software]
Critical thinking
HIPAA compliance
Multitasking
Problem-solving
Telephone etiquette
Appointment scheduling
Documentation and paperwork
Schedule management
Application review
Payment collection
Conflict resolution
Applicant engagement
Teamwork and collaboration
Attention to detail
Reliability
Excellent communication
Organizational skills
Active listening
Timeline
Prior Authorization Specialist
Travel Nurses Across America
03.2026 - CurrentRead More
Enrollment and Family Support Specialist
Conversion Calls
04.2025 - 02.2026Read More
Sales Representative
Alta Resources
10.2021 - 06.2024Read More
Customer Care Representative
Alta Resources
08.2020 - 10.2021Read More
Restaurant Waiter
East Troy Brewery
09.2018 - 04.2020Read More
Excell High School
High School Diploma
Read More