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
2023.10 - 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
2019.03 - 2023.10
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
2016.04 - 2017.08
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, MN
2014-06
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
2023.10 - Current
Technical Clinical Operations Associate
Prime Therepeutics
2019.03 - 2023.10
Designated Hitter
Walgreens
2016.04 - 2017.08
High School Diploma -
Patrick Henry High School
Similar Profiles
Sai Inesh NallamothuSai Inesh Nallamothu
Medical Clinic Shadowing at Mayo Clinic and the Minneapolis Clinic of NeurologyMedical Clinic Shadowing at Mayo Clinic and the Minneapolis Clinic of Neurology