Summary
Overview
Work History
Education
Skills
Timeline
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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
Lilian Zheng