Maranda Moore
Beaumont
Summary
Dynamic Prior Authorization Specialist with proven expertise at Cigna in streamlining authorization processes and enhancing patient access to care. Skilled in medical terminology and insurance verification, I excel in maintaining compliance and accuracy. Known for professionalism and a commitment to quality, I effectively collaborate with healthcare providers to resolve complex issues.
Overview
7
7
years of professional experience
Work History
Prior Authorization Specialist
Cigna
Remote
05.2023 - Current
- Processed prior authorization requests efficiently to ensure timely patient access to medications and services.
- Collaborated with healthcare providers to verify patient eligibility and insurance coverage details.
- Utilized electronic health record systems to document authorization outcomes and maintain accurate records.
- Reviewed medical documentation for compliance with clinical guidelines and payer policies, ensuring accuracy.
Medical Claims Processor
BroadPath Healthcare
Remote
06.2021 - 05.2023
- Processed medical claims efficiently, ensuring compliance with regulatory requirements and organizational policies.
- Reviewed claim submissions for accuracy, identifying discrepancies and facilitating timely resolutions.
- Collaborated with healthcare providers to gather necessary documentation for claim adjudication.
- Utilized electronic health record systems to input and track claims data, enhancing workflow efficiency.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Monitored and updated claims status in claims processing system.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
Data Entry Clerk
EA Solutions
Beaumont, TX
06.2019 - 06.2021
- Processed high volumes of data entries with accuracy and attention to detail.
- Managed electronic filing systems, ensuring efficient data retrieval and organization.
- Collaborated with team members to streamline data entry workflows and enhance overall productivity.
- Conducted regular audits of data to verify accuracy and identify discrepancies promptly.
- Implemented quality control measures, reducing errors in data entries significantly over time.
- Completed data entry tasks with accuracy and efficiency.
- Organized, sorted, and checked input data against original documents.
Education
High School Diploma -
Central Medical Magnet High
Beaumont, TX06.2012
Skills
- Prior authorization process
- Medical terminology
- Medical appeals handling
- Authorizations
- Insurance verification
- Data entry
- Electronic health records proficiency
- Medical terminology knowledge
- Benefit coverage
- Professionalism and ethics
- Billing procedures
- Insurance procedures
- Workflow management
Timeline
Prior Authorization Specialist
Cigna
05.2023 - Current
Medical Claims Processor
BroadPath Healthcare
06.2021 - 05.2023
Data Entry Clerk
EA Solutions
06.2019 - 06.2021
High School Diploma -
Central Medical Magnet High