Lillian Grier
Winston-Salem,,NC
Summary
Healthcare professional with 6+ years of experience in healthcare administration, including 4+ years of experience supporting prior authorization, insurance verification, patient access, and payer requirements. Experienced in coordinating authorization requests for medical procedures, services, medications, and treatments; reviewing eligibility and benefits; communicating with insurance carriers and healthcare providers; and monitoring approved, denied, and appealed requests. Proficient in EPIC, insurance processing, medical documentation, and accurate data entry, with a strong focus on timely and compliant authorization processing.
Overview
9
9
years of professional experience
Work History
Switchboard Operator
Atrium Health
Winston-Salem, NC
08.2024 - Current
- Provide responsive telephone support to patients, hospital employees, medical staff, and the public by accurately answering and routing switchboard calls.
- Update telephone and pager information within switchboard systems and maintain on-call schedules.
- Provide backup support to Customer Service Representatives by receiving, documenting, and dispatching service requests.
- Communicate with clinical departments regarding schedule discrepancies and missing information.
Pre Authorization Specialist II
Novant Health
Winston-Salem, NC
05.2020 - 08.2024
- Coordinated prior authorization requests for medical procedures, services, medications, and treatments to support timely patient care.
- Reviewed patient insurance eligibility, benefits, coverage requirements, and authorization guidelines to ensure accurate submissions.
- Communicated with insurance carriers, healthcare providers, pharmacies, and clinical staff regarding authorization status, requirements, and next steps.
- Monitored authorization requests through the approved, denied, and appealed stages, completing appropriate follow-up within required timeframes.
- Maintained detailed and accurate authorization information while coordinating with multiple parties throughout the authorization process.
Patient Access Specialist
Novant Health
Winston Salem, NC
02.2018 - 04.2020
- Performed patient pre-registration, registration, and insurance verification while accurately collecting demographic and financial information.
- Communicated financial responsibilities and collected point-of-service payments when necessary.
- Submitted insurance claims and collaborated with healthcare providers to support accurate and timely claim processing.
- Performed documentation audits to ensure compliance with payer requirements, including Medicare, and verified medical necessity and plan-of-care documentation.
Education
Diploma - Medical Office Administration - Outpatient Coding
Forsyth Technical Community College
08.2021
Certificate of Completion - Medical Office Administration - Advanced Coding
Forsyth Technical Community College
Winston-Salem, NC12.2020
Skills
- Prior Authorization
- Insurance Verification
- Insurance Eligibility
- Benefits Verification
- Medical Terminology
- Claims Processing
- Patient Registration
Timeline
Switchboard Operator
Atrium Health
08.2024 - Current
Pre Authorization Specialist II
Novant Health
05.2020 - 08.2024
Patient Access Specialist
Novant Health
02.2018 - 04.2020
Diploma - Medical Office Administration - Outpatient Coding
Forsyth Technical Community College
Certificate of Completion - Medical Office Administration - Advanced Coding
Forsyth Technical Community College