Lisa Hepfer
Felton,PA
Summary
Results-driven Managed Care Representative with expertise in insurance claims investigation and prior authorization processing. Proven ability to streamline processes, enhance patient satisfaction, and maintain compliance with industry regulations.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Managed Care Representative
Wellspan Health
York, PA
04.2010 - Current
- Facilitated communication between patients and healthcare providers to resolve care issues.
- Managed insurance verification processes, ensuring timely authorizations for patient services.
- Streamlined claims processing by implementing standardized procedures and reducing errors.
- Provided training and mentorship to new representatives on best practices in managed care operations.
- Improved patient satisfaction by providing timely and accurate information on managed care plans.
- Enhanced operational efficiency by streamlining processes for benefit verification and eligibility determination.
- Resolved escalated issues promptly and professionally, preserving positive relationships with providers and members alike.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
Claims Representative
PDP Group
Hunt Valley, MD
09.1996 - 09.2007
- Processed claims efficiently, ensuring compliance with company policies and industry regulations.
- Assisted in resolving complex customer inquiries, enhancing overall satisfaction and retention rates.
- Collaborated with cross-functional teams to streamline claims processing workflows, reducing turnaround times.
- Trained junior staff on best practices for claims management and utilization of internal systems.
Education
High School Diploma -
Kennard-dale
Fawn Grove, PANo Degree - Medical Terminology
York Vocational Technical School
York, PA 04-2009
Certificate -
Consolidated School of Business
York, PA 08-1984
Skills
- Strong negotiation
- Healthcare
- Analytical mindset
- Insurance expertise
- Claims investigation
- Prior authorization processing
Certification
- Certified CPR Training
- Medical Terminology
Timeline
Managed Care Representative
Wellspan Health
04.2010 - Current
Claims Representative
PDP Group
09.1996 - 09.2007
High School Diploma -
Kennard-dale
No Degree - Medical Terminology
York Vocational Technical School
Certificate -
Consolidated School of Business