Kua Lor
Minneapolis,MN
Summary
Skilled team player with a strong background in fast-paced environments, adept at working independently and always eager to learn new things.
Overview
8
8
years of professional experience
Work History
Prior Authorization Specialist
Minneapolis Clinic of Neurology
Golden Valley, MN
10.2023 - Current
- Verified patient insurance coverage, eligibility, benefits and authorizations for medical services.
- Conducted thorough medical reviews for prior authorization requests in accordance with established criteria.
- Followed up on pending prior authorization requests for timely processing.
- Maintained accurate and up-to-date records of authorization requests and outcomes in electronic health record systems.
- Served as the main point of contact for patients, effectively addressing inquiries and updating patient account information.
Technical Clinical Operations Associate
Prime Therepeutics
Eagan, MN
03.2019 - 10.2023
- Ensured appropriate claims adjudication by accurately inputting prior authorizations into the claim system.
- Audit and judiciously completed highly detailed investigations on claims, and fully documented files with pertinent information.
- Performed outreach to pharmacies and physicians' offices, ensuring verification and acquisition of necessary clinical information.
- Efficiently responded to calls and emails, effectively managing work queue and volumes, meeting client-specific turnaround times.
- Utilized Excel and Word Document to communicate clinical outcomes to members and physicians, ensuring timely delivery.
Designated Hitter
Walgreens
Minneapolis, MN
04.2016 - 08.2017
- Delivered exceptional customer service by effectively utilizing active listening and problem-solving abilities.
- Assisted in replenishing inventory on floor and backroom.
- Maintained cleanliness and organization in the work environment.
Education
High School Diploma -
Patrick Henry High School
Minneapolis, MN06-2014
Skills
- Strong verbal and written communication skills
- Attention to detail
- Able to work independently
- Excellent customer service
Timeline
Prior Authorization Specialist
Minneapolis Clinic of Neurology
10.2023 - Current
Technical Clinical Operations Associate
Prime Therepeutics
03.2019 - 10.2023
Designated Hitter
Walgreens
04.2016 - 08.2017
High School Diploma -
Patrick Henry High School
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