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
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
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
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
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
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
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