Lakeshia Jackson
Wiggins,Mississippi
Summary
Talented Prior Authorization Representative with years of implementing strategies to secure authorizations for clinical procedures. Expert delivering continuous clinical quality improvement. Superb influencing skills to communicate with credibility, tact and diplomacy.
Overview
10
10
years of professional experience
Work History
Prior Authorization Representative
Transparent Healthcare Group
Marlton, NJ
07.2019 - 08.2024
- Process and review prior authorization requests for various medical procedures and treatments.
- Verify patient eligibility and benefits through insurance portals and provider networks.
- Collaborate with healthcare providers and insurance companies to gather necessary documentation and ensure timely approvals.
- Maintain accurate records of authorization requests and decisions in compliance with company and regulatory standards.
- Address and resolve authorization-related issues and denials, providing detailed explanations and alternative solutions to patients and providers.
- Educate patients on authorization processes and insurance benefits, improving understanding and compliance.
Senior Member Service Representative
Concentrix
Jacksonville, FL
01.2017 - 06.2019
- Assist members with inquiries related to membership benefits, account status, and service issues via phone, email, and in-person.
- Process membership applications, renewals, and cancellations, ensuring accurate and timely updates to member accounts.
- Resolve member complaints and concerns with a focus on providing solutions and maintaining high satisfaction levels.
- Maintain detailed records of member interactions and transactions using [CRM Software/Database].
- Collaborate with other departments to address and resolve complex member issues and provide feedback for service improvements.
Member Service Specialist
Alorica
Saraland, AL
08.2014 - 01.2017
- Coordinated patient scheduling, managed medical records, and handled patient inquiries.
- Assisted in the preparation and submission of insurance claims and prior authorization requests.
- Verified patient insurance coverage and processed referrals to specialists.
- Maintained up-to-date knowledge of insurance policies, coding, and billing practices.
- Provided exceptional customer service to members and guests by answering inquiries, resolving complaints, and providing information in a timely manner.
Education
Associate of Arts - Language Arts Education
Mississippi Gulf Coast Community College
Perkinston, MS05-2006
Skills
- Patient insurance authorizations
- Patient Scheduling
- Insurance Verification
- Follow-up skills
- Co-payment collection
- Medical Coding
Timeline
Prior Authorization Representative
Transparent Healthcare Group
07.2019 - 08.2024
Senior Member Service Representative
Concentrix
01.2017 - 06.2019
Member Service Specialist
Alorica
08.2014 - 01.2017
Associate of Arts - Language Arts Education
Mississippi Gulf Coast Community College
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