Mareeta White
Streetsboro,OH
Summary
Analytical professional proficient in information gathering, report preparation and data compilation capabilities. In-depth knowledge of insurance coverage forms, procedures, and policies. Accommodating and logical individual skillful in creating customized requests for each client.
Overview
4
4
years of post-secondary education
12
12
years of professional experience
Work History
Prior Authorization Representative/Quality Auditor
Cigna
01.2023 - Current
- Processed eligibility and authorization requests, ensuring adherence to clinical and policy guidelines to facilitate timely patient care. Audited member records and documentation for accuracy and compliance with HIPAA and internal standards, supporting regulatory adherence. Analyzed information to ensure accuracy. data from multiple sources to identify discrepancies and resolve errors, recommending process improvements to enhance operational efficiency. Maintain a 95%+ accuracy rate while meeting turnaround times in a fast-paced, dynamic environment. Communicate professionally with leadership and team members to support business operations and compliance.
- Performed job duties from a remote location.
- Reviewed prior authorization requests for Cigna health plan members.
- Confirmed eligibility status for insurance plans. and plan benefits before processing authorization cases.
- Contacted providers to obtain necessary clinical documents. with providers about missing clinical documentation.
Customer Service Representative
New York Life Insurance
01.2017 - 01.2020
- Processed policy and eligibility data accurately and confidentially, ensuring compliance with internal and regulatory standards. Conducted detailed record audits to ensure compliance with internal and regulatory requirements. Resolved customer issues and clarified complex information through effective communication with customers and management. Implemented process improvements that increased data accuracy and streamlined processing time.
- Provided support in both remote and office settings.
- Resolved customer issues through phone, email, and written correspondence.
- Assisted New York Life policyholders with life insurance and annuity inquiries.
- Reviewed policy changes, beneficiary updates, and premium payment requests.
Quality Auditor
University Hospitals
Cleveland, OH
01.2015 - 01.2017
- Audited hospital documentation for compliance with University Hospitals quality standards.
- Reviewed patient care records for accuracy and policy alignment.
- Monitored staff adherence to clinical procedures and safety guidelines.
- Verified insurance eligibility and maintained accurate patient records to support billing accuracy. Audited scheduling data to prevent billing errors and ensure compliance with hospital procedures, enhancing overall operational integrity. Identified workflow gaps and proposed corrective actions to support operational efficiency.
Education
Bachelor's Degree - human resource management
DeVry University
Columbus, OH 04.2022 - 09.2026
Skills
- Claims processing
- Decision-making troubleshooting
- Data auditing and analysis
- Data Processing
- Healthcare software proficiency
- Microsoft Excel
- Microsoft Office proficiency
- Compliance & Confidentiality (HIPAA)
- HIPAA compliance
- Record Verification
- Analytical Thinking & Problem Solving
- Decision-making troubleshooting
- Time Management & Prioritization
- Cross-functional communication
- Professional communication skills
- Medical terminology
- Data Processing
Personal Information
Title: Analytical Professional in Healthcare Operations & Quality Auditing
Timeline
Prior Authorization Representative/Quality Auditor
Cigna
01.2023 - Current
Bachelor's Degree - human resource management
DeVry University
04.2022 - 09.2026
Customer Service Representative
New York Life Insurance
01.2017 - 01.2020
Quality Auditor
University Hospitals
01.2015 - 01.2017