Leigh Ann Clark
Winchester,VA
Summary
Trustworthy professional offering a keen understanding of the latest insurance requirements for prior authorizations. An individual who is looking for long term employment in a non-toxic environment where patient's needs are the first priority. I have experience in Family Medicine, Otolaryngology, Opthalmology and Dermatology and wish to share my knowledge and skills for the betterment of my employer.
Overview
7
7
years of professional experience
Work History
Prior Authorization Specialist
NEBH/Olive/Verata
Boston, MA
07.2019 - Current
- Processed and completed 300-400 Prior authorization requests monthly for a well established Orthopedic group in Boston Massachusetts.
- Reviewed requirements needed to process Prior Authorizations to avoid Peer To Peer reviews.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills. Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Utilized a "dashboard" to ensure adequate follow up processes were utilized.
- Completed all necessary forms necessary for submitting.
- Utilized numerous portals for submissions.
Triage Specialist
Dermatology Associates of Winchester
Winchester, VA
10.2016 - 07.2019
- Triage Nurse for Dermatology which included giving out test results, refilling medication, patient interaction on all levels.
- Soley responsible for all inventory for 3 locations including all medical supplies for dermatology practice and Mohs surgeon.
- Soley responsible for all Collections for dermatology practice.
- Assisted manager with most Human Resources including benefits, PTO, employee scheduling, audits and managing MD's personal information.
- I was trained in many jobs at Dermatology which included phone triage, front desk, billing, and Medical Assistant duties.
- Maintained a schedule for Blue Light, Phototherapy, Narrowband laser and Patch Testing while keep meticulous records for patients care.
- Completed Prior Authorizations for prescriptions which included researching tried and failed medications, and biologics which included topical medications and injections.
Opthalmic Technician
Eye Associates of Winchester
Winchester, VA
06.2017 - 05.2019
- Administered ophthalmic drops and ointments for treatment or to aid in diagnostics.
- Assisted ophthalmologist with patient examinations, including taking and recording vital signs and medical history.
- Assisted physicians during minor surgical procedures such as foreign body removal.
- Instructed patients on how to properly apply eye drops or other medications prescribed by the physician.
- Prepared exam rooms according to established protocols prior to each patient visit.
- Advised patients on ocular medications, dressings and contact lenses.
- Collected essential medical information and documented data in EHR platform.
- Completed Prior Authorizations for patients when samples of medications were unavailable and prior authorizations were needed. This includes completing forms and showing medical necessity. Prior authorizations ranged from drops, gels and oral medication due to Glaucoma etc.
Education
High School Diploma -
James Wood High School
Winchester, VA06-1997
Skills
- Insurance Procedures
- Precertification Requirements
- Understanding of Medical Terms
- Very organized, great communication skills
- Able to work independently, requires little supervision
References
References available upon request.
Timeline
Prior Authorization Specialist
NEBH/Olive/Verata
07.2019 - Current
Opthalmic Technician
Eye Associates of Winchester
06.2017 - 05.2019
Triage Specialist
Dermatology Associates of Winchester
10.2016 - 07.2019
High School Diploma -
James Wood High School
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