Lilian Zheng
Summary
Experienced professional with 6 years of experience and solid background as Subject Matter Expert in providing valuable insights and solutions, contributing to success of various projects. Known for reliability and adaptability in dynamic environments. Exceptional at fostering teamwork, collaboration and driving successful outcomes.
Overview
10
10
years of professional experience
Work History
Prior Authorizations - Subject Matter Expert
United Healthcare, UHG
07.2023 - Current
- Facilitate new-hire trainings and guide transitioning of employees full cycle.
- Develop and implement training programs for new hires, ensuring a smooth onboarding experience.
- Recognize trends, analyze changes in processing, and create reports and tools of alignment for employees.
- Prepare meeting materials, audit cases for accuracy, providing guidance in ensuring compliance with company regulations.
- Establish and document best practices for processing prior authorizations, enhancing team productivity.
- Collaborate with cross-functional teams to streamline prior authorization workflows, enhancing overall efficiency.
- Provide ongoing support to team members, fostering a positive work environment and encouraging teamwork.
- Process over 300 prior authorization requests daily with 100% accuracy.
Third Party Exceptions Processing
The Pill Club
04.2021 - 04.2023
- Processed over 500 patient claims daily through third party insurance and cash orders, ensuring accuracy in all transactions.
- Managed the processing of sensitive prescription information into EHR software, adhering to the necessary workflows.
- Conducted thorough analysis and correspondence with patients and pharmacies to address inquiries and relay prescription status.
- Utilized problem-solving skills to troubleshoot and resolve discrepancies in claims processing, minimizing delays.
- Developed and documented standard operating procedures for exceptions processing, improving team efficiency.
- Trained new team members on exception processing protocols, fostering a knowledgeable and skilled workforce.
- Monitored and reported on claims processing trends, providing actionable insights to improve overall operations.
Teaching Assistant
Kumon North America
09.2015 - 04.2021
- Oversee several hundred students per day tracking their progress
- Create reference guides for high school students that has been adapted throughout the center
- Parent-teacher liaison performing tasks including answering phone calls, and providing information regarding the program and students' progress
- Create smooth transitioning into fully distant learning while retaining success of students
Education
Bachelor of Science - Business Management and Administration
San Francisco State University
01.2019
Skills
- Training and mentoring
- Strong analytical skills
- Customer focus
- Attention to detail
- Innovative mindset
- Creative solutions
- Teamwork and collaboration
- Excellent communication
Timeline
Prior Authorizations - Subject Matter Expert
United Healthcare, UHG
07.2023 - Current
Third Party Exceptions Processing
The Pill Club
04.2021 - 04.2023
Teaching Assistant
Kumon North America
09.2015 - 04.2021
Bachelor of Science - Business Management and Administration
San Francisco State University