Lacediia Welch

• Handled prior authorization requests for diverse medical specialties, such as plastic surgery, Physical Medicine and otolaryngology.
  Coordinated with medical offices to facilitate timely approvals for various procedures.
  Maintained accurate records of authorization processes to ensure compliance.
  Streamlined communication with providers to expedite information gathering for authorizations.

I took inbound Behavioral Health calls from Providers and their affiliates. Provided guidance to providers regarding the prior authorization process. We were required to advise provider offices on proper coding practices that are necessary for successful claim submission. I also

utilized medical coding knowledge to accurately process and document authorization requests.

Handled high-volume calls while maintaining positive customer engagement. Answered customer inquiries and provided accurate information regarding products and services for Ohio Medicaid Members. I was required to maintain detailed records of customer interactions, transactions and comments for future reference. I was also responsible for

Resolving customer complaints efficiently and professionally.

We Reviewed prior authorization requests to ensure accuracy and completeness of required information.

Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients. Also notified ordering providers of denied authorizations. Maintained accurate

records of all authorization activities in the database system.

Developed relationships with external vendors providing pre-authorization services.

As a pre-registration specialist. We were responsible for managing patient registration using electronic health record systems. To Collect and verify

patient information for accuracy.

Resolving patient concerns regarding registration processes efficiently.

Verify insurance coverage for incoming patients and ensure that all documents are accurate and up to date. Also maintain confidentiality of all protected health information as required by HIPAA regulations.