Leanna Taylor
Florissant,Missouri
Summary
Works cooperatively with others, Encourages participation, Values the contribution of all team members. Fosters a sense of urgency, identifies and overcomes obstacles, balances the big picture with day-to-day activities/issues, persistent in the pursuit of results. Listens carefully, solicits other opinions, Creates new channels of communication in workplace. Self-starter, able to work alone and as part of a team. Professional with over 9 years of diversified Customer/Consumer Service, and Clerical experience. Excellent written and oral communication skills. Ability to handle multiple tasks simultaneously and be proficient with attention to detail. Self-starter with high energy and a strong commitment to quality. Excellent customer/client retention skills
Overview
13
13
years of professional experience
1
1
Certification
Work History
Prior Authorization Coordinator
Optum
Remote
12.2022 - Current
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
- Reduced errors in documentation by meticulously reviewing medical records and verifying patient information.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Collected and processed patient liability statements prior to service.
- Contributed to improved patient outcomes by staying current on industry trends and changes in regulatory standards related to prescription drug coverage policies.
- Demonstrated exceptional problem-solving skills, addressing challenges related to patient care coordination and insurance requirements with a solutions-oriented mindset.
- Ensured compliance with state and federal regulations through diligent monitoring of prior authorization processes.
- Expedited the approval process for vital medications by maintaining a strong working relationship with insurance providers.
- Adapted quickly to shifting priorities within the department, demonstrating flexibility and resiliency under pressure while remaining focused on achieving desired results.
- Enhanced workflow management within the department, implementing strategies to prioritize urgent cases and manage workload effectively.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Performed various administrative tasks by filing, copying and faxing documents.
Direct Support Professional
Compass Health Network
Saint Peters, MO
04.2022 - Current
- Maintained clean, safe, and well-organized patient environment.
- Documented progress notes thoroughly to track client achievements, concerns, or changes in behavior patterns that may need attention from the interdisciplinary team.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Assisted with crisis intervention to de-escalate challenging behavior and maintain peaceful encounters.
- Enhanced quality of life for individuals with disabilities by providing compassionate and consistent direct support.
- Supported clients with personal care tasks, ensuring their dignity and privacy were maintained at all times.
- Monitored medication administration, maintaining accurate records to ensure client safety and compliance with prescribed treatment plans.
- Participated in ongoing training opportunities to stay current on best practices in disability support services.
- Assisted disabled clients to support independence and well-being.
- Monitored clients to assess and report physical and behavioral changes to supervisors.
- Addressed emergency situations calmly and effectively, prioritizing the safety of both clients and staff members involved.
- Transported clients to medical and dental appointments to provide support.
- Improved client self-sufficiency through teaching essential skills such as meal preparation, housekeeping, and financial management.
- Improved clients' daily living skills with hands-on teaching and encouragement, promoting independence.
- Trained new staff on best practices in direct support, elevating overall quality of care provided.
- Cooked meals and assisted patients with eating tasks to support healthy nutrition.
- Supported daily hygiene needs of patients by assisting with bathing, dressing, dental care and personal grooming.
- Assisted patients with bathing, grooming, dressing, and oral hygiene care both in private residences and facilities.
- Transported clients to and from medical appointments with safety and efficiency.
- Entrusted to handle confidential and sensitive situations in professional matter.
- Completed regular check-ins and progress report for each client.
- Recorded patients' pulse, blood pressure and respirations (TPRs) to assess and document important health information.
Provider Advocate
UnitedHealth Group
Maryland Heights
05.2017 - 11.2022
- Answering inbound calls with greetings from the company
- Assisting providers with claim information for patients and sending back any adjustments for reprocessing that needs to be corrected on claim
- Initiating prior authorization request, giving status and updating cases
- Providing provider with benefits and eligibility details regarding members
- Help find solutions to meet the need of the providers claims filed for the patient
- Help resolve any concerns or issues provider may have
- Demonstrated ability to listen skillfully, collect relevant information
- Build rapport and respond to providers in compassionate manner
- Assist in efforts to empower providers through use of provider portal, administrative updates and future service enhancements.
Customer Service Representative
Convergys
St. Louis
07.2014 - 04.2017
- Answer incoming calls from customers and assist with customer needs
- Listen actively and ask questions that need to be answered appropriately
- Open customers accounts by recording account information
- Resolve customer issues and come up with the best solution to solve the problem
- Expediting corrections or adjustment
- Follow up to ensure the resolution
- Update personal information if anything changed with customer.
Community Living Instructor
Easter Seals
Saint Louis
11.2011 - 05.2013
- Assist consumers with developmental disabilities with daily life activities including personal care, household chores, shopping, and recreational and social activities
- Provide companionship and emotional support to each individual served
- Mentor new and existing staff
- Assure daily activities are completed through job delegation
- Assure all consumers doctor's appointments are scheduled
- Assure all information in the consumers books are kept updated and inform the Program Manager of any changes in the consumers life
- Monitor client spending and maintain accurate ledgers assuring all bills are paid in a timely fashion
- Handle reporting any health issues to the supervising nurse
- Responsible for emptying consumers catheter bags
- Responsible for monitoring vital signs including pulse, respiration, and blood pressure levels
- Assist consumers during feeding
- Assist consumers with upkeep of their space
- Responsible for picking consumers up from work and scheduled programs.
Education
General high school -
Normandy High School
Saint Louis, MO05.2009
Skills
- Computer skills
- Customer service
- Microsoft excel
- Microsoft office
- Communication skills
- Microsoft word
- Windows
- Writing skills
- Typing
- Analysis skills
Certification
CPR
First Aid
LMA1
CPI
Notary Public
Timeline
Prior Authorization Coordinator
Optum
12.2022 - Current
Direct Support Professional
Compass Health Network
04.2022 - Current
Provider Advocate
UnitedHealth Group
05.2017 - 11.2022
Customer Service Representative
Convergys
07.2014 - 04.2017
Community Living Instructor
Easter Seals
11.2011 - 05.2013
General high school -
Normandy High School