Lindsey Woodward
Prior Authorization Specialist
Gillett,PA
Summary
Detail-oriented Prior Authorization Specialist with a successful background working closely with insurance company representatives to gain pre-approval for imaging, procedures, and medications. Skilled in EMR systems such as Epic and adept at maintaining HIPAA compliance. Positive team player with exemplary multitasking and self-motivating skills.
Overview
6
6
years of professional experience
Work History
Contract Infusion Authorization Specialist
Apex Systems/Barnes Jewish Hospital
Remote
04.2024 - 06.2024
- Assisted with a time-sensitive project with an infusion center merge from an office to outpatient hospital setting with high-dollar chemotherapy treatment plans.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Improved patient satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Facilitated smooth transitions between different levels of care by coordinating required authorizations for patients moving from one service setting to another.
Pharmacy Coordinator, Patient Accounting Rep
CNY Fertility Center
Remote
07.2023 - 04.2024
- Responded via inbound/outbound phone calls, web correspondences, emails, and other communications with patients timely, efficiently, and compassionately.
- Helped patients navigate the financial options and responsibilities throughout their fertility journey, ensuring clear understanding of any self-pay or insurance charges and payment options.
- Assisted with questions and review of patient ledgers regarding current and past-due balances in both Practice Manager and eIVF software.
- Provided excellent customer service by de-escalating patient issues with empathy, understanding, and resolution in a prompt and professional manner.
Patient Service Center Representative
Conifer Health Solutions
Remote
02.2022 - 06.2023
- Initiated and obtained prior authorization accurately and timely prior to the scheduled date of service with appropriate payor(s)
- Updated patient referral notes in Epic software that meet and/or succeed quality guidelines
- Provided daily follow-up on assigned cases, and when necessary, contacted the facility and/or the ordering providers office with updates regarding clinical documents needed, peer-to-peer options and timeframe, and denial information.
Contract Data Entry/Intake Specialist
Cohere Health
Remote
10.2021 - 02.2022
- Assisted facilities and providers offices via phone, email, fax, and other communication platforms in a timely and professional manner while following company scripts, processes, and guidelines, and maintaining HIPAA compliance.
- Obtained all necessary information for clinical review completion within State and Federal guidelines for TAT (turnaround times).
- Answered inbound calls to assist with authorization process by initiating authorization, providing case status, and guiding new users with portal registration using company protocol via Salesforce and Confluence.
- Maintained high levels of accuracy and compliance in data entry, ensuring all information was correctly entered into the required systems.
Shipping & Receiving Clerk, Inside Sales Rep
Kennedy Valve
Elmira, NY
09.2018 - 08.2021
- Developed and maintained strategic, professional relationships with distributors, sister-company personnel, existing customers, and outside sales representatives located in my eleven designated states and two assigned international territories.
- Demonstrated excellent communications with up-to-date knowledge via high-volume calls and emails regarding pricing and available products to best serve customers and maximize sales potential.
- Accurately entered high-dollar purchase orders into company software by allocating product from inventory while collaborating with internal departments to ensure customer satisfaction, order accuracy, and completion of product within expected timelines.
- Corresponded with carrier representatives to make arrangements and provide instructions for shipment and delivery, expediting as necessary, and communicating variances to customers.
- Drafted and managed work and shipping orders, bills of lading, and shipping route materials for accurate and compliant record-keeping.
Billing Specialist
CASA-Trinity of Chemung County
Elmira, NY
12.2017 - 07.2018
- Verified client insurance eligibility and obtained necessary authorizations and maximize agency cash flow by also working insurance denials and appeals
- Corresponded clearly and professionally via phone, email, or face-to-face meetings while collaborating with clinical staff to obtain all necessary documentation required for billing patients, Medicaid, or other insurance parties
- Maintained accurate and timely records in the agency database and EMR (10e11) to process billing and track client balances.
Education
Certificate Of Completion - Medical Technology
Northern Tier Career Center
Towanda, PA06.2009
High school diploma - General Studies
Athens Area High School
Athens, PASkills
- Utilization Management
- EMR Systems
- HIPAA
- Epic
- Microsoft Office
- Insurance verification
- Payer Portals
- Medical Terminology
- ICD-10
- Gastroenterology
- Fertility/Reproductive Endocrinology
- Diagnostic Radiology
- Chemotherapy & Infusion Services
- Documentation Review
- Attention to detail
- Salesforce
- Confluence
Timeline
Contract Infusion Authorization Specialist
Apex Systems/Barnes Jewish Hospital
04.2024 - 06.2024
Pharmacy Coordinator, Patient Accounting Rep
CNY Fertility Center
07.2023 - 04.2024
Patient Service Center Representative
Conifer Health Solutions
02.2022 - 06.2023
Contract Data Entry/Intake Specialist
Cohere Health
10.2021 - 02.2022
Shipping & Receiving Clerk, Inside Sales Rep
Kennedy Valve
09.2018 - 08.2021
Billing Specialist
CASA-Trinity of Chemung County
12.2017 - 07.2018
Certificate Of Completion - Medical Technology
Northern Tier Career Center
High school diploma - General Studies
Athens Area High School