Lauren White
Ferriday,LA
Summary
Detail-oriented professional with expertise in client service and HIPAA compliance. Proven ability to process prior authorization requests efficiently, ensuring timely access to medications and exceptional patient communication.
Overview
14
14
years of professional experience
Work History
Prior Authorization Representative
Navitus (Everise)
Remote
01.2025 - Current
- Processed prior authorization requests efficiently to ensure timely patient access to medications.
- Collaborated with healthcare providers to gather necessary documentation for authorization approvals.
- Utilized electronic health records and claims processing systems to verify patient eligibility and benefits.
- Communicated clearly with patients regarding the status of their prior authorization requests and next steps.
- Resolved discrepancies in authorization submissions through meticulous review and follow-up procedures.
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
Member Service Representative
RxBenefits (Everise)
Remote
09.2023 - 01.2025
- Managed member inquiries regarding benefits and eligibility with accuracy and professionalism.
- Educated members on plan features, enhancing understanding and satisfaction with services.
- Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
- Address customer issues and ensure effective and long-term problem resolution. Communicate with other professionals such as various PBM (Express Scripts, CVS Caremark & Optum) pharmacy staff, pharmacists, medical office staff and physicians to resolve customer needs.
- Partner with Account Management and sales staff to provide customers with excellent service.
- Effectively handle complaints while consistently demonstrating behaviors that are respectful and contribute to good service.
- Learn multiple software systems to service all client needs and products.
Customer Care Consultant
Progressive
Remote
06.2017 - 01.2023
- Resolved customer inquiries efficiently, enhancing overall satisfaction and loyalty.
- Delivered outstanding support during peak periods, adeptly handling increased call volume without compromising service quality.
- Support customers inquiries and insurance policy needs by answering questions regarding coverages, rates, billing issues and general policy reviews while offering additional products to bundle.
Caseworker I
EMSI
Remote
01.2015 - 05.2017
- Facilitated client assessments to identify needs and develop personalized service plans.
- Coordinated with community resources to ensure comprehensive support for clients.
- Monitored case progress and adjusted strategies to enhance client outcomes.
- Conducted regular follow-ups to maintain engagement and address emerging issues.
Customer Care Representative
Direct Auto & Life Insurance
Baton Rouge, LA
01.2012 - 12.2014
- Resolved customer inquiries and issues through effective communication and problem-solving techniques.
- Educated clients on insurance products, enhancing customer understanding and satisfaction.
- Utilized CRM systems to track interactions and manage service requests efficiently.
- Collaborated with team members to streamline processes, improving response times for customer queries.
Education
Bachelor of Science - Psychology
Southern University And A&M College
Baton Rouge, LA12-2011
High School Diploma -
Ferriday High School
Ferriday, LA05-2001
Skills
- Basic medical terminology
- Authorizations
- Benefit coverage
- HIPAA compliance
- Insurance verification
- Data entry proficiency
- Client service
- Follow-up skills
- Healthcare industry
- Electronic records management
- ICD-10 coding
- Proficiency in [software]
- Teamwork
- Customer service
- Problem-solving
- Time management
- Multitasking
- Problem-solving abilities
- Attention to detail
- Active listening
Timeline
Prior Authorization Representative
Navitus (Everise)
01.2025 - Current
Member Service Representative
RxBenefits (Everise)
09.2023 - 01.2025
Customer Care Consultant
Progressive
06.2017 - 01.2023
Caseworker I
EMSI
01.2015 - 05.2017
Customer Care Representative
Direct Auto & Life Insurance
01.2012 - 12.2014
Bachelor of Science - Psychology
Southern University And A&M College
High School Diploma -
Ferriday High School