Meagan Mosher
Rome,PA
Summary
Dedicated Prior Authorization Representative adept in obtaining prior authorization for all patients. Patient, kind and proficient in delivering timely service. Ready to apply expertise in Insurance- Customer, PT service to a dynamic new position.
Trustworthy professional offering a keen understanding of the latest insurance requirements for prior authorizations. Determined Prior Authorization Specialist boasting extensive claim researching and effective collaboration skills with other members of the office staff.
Detail-oriented Prior Authorization Specialist proudly offering over 2 years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments.
Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
7
7
years of professional experience
Work History
Prior Authorization Representative
Arnot Ogden Medical Center
Elmira, NY
11.2022 - Current
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Maintained accurate records on all prior authorizations requested, received, and denied.
- Advised healthcare professionals on proper coding practices that meet requirements of payers.
- Provided timely feedback to physicians regarding authorization status.
- Developed strategies for resolving complex issues concerning benefit coverage determinations.
- Communicated with internal teams regarding changes in policy or procedure related to prior authorization process.
- Reviewed written correspondence, correcting grammatical and spelling errors.
- Facilitated communication between health plan representatives, providers, and members when needed.
- Assessed insurance benefits and determined eligibility criteria.
- Researched medical policies to ensure appropriate coverage of services.
- Followed all Medicare, Medicaid, HIPAA and private insurance regulations and requirements.
- Coordinated resolutions for issues and appealed denied authorizations.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Submitted prior authorization requests electronically or by phone to payers.
Picker
CVS Warehouse Distribution Center
CHEMUNG, NY
04.2019 - 08.2022
- Reported any damaged or defective items immediately to supervisor for further investigation.
- Kept work areas clean, neat and organized for optimal productivity and worker safety.
- Received and counted stock items, recording data manually or on computer for inventory purposes.
- Read orders to verify attributes and quantities of merchandise.
- Demonstrated great teamwork skills with staff members involved in production and transport.
- Inspected merchandise for wear or defects, disposing of damaged items as instructed by supervisors.
- Received and processed customer orders for merchandise in a timely manner.
- Communicated with supervisors regarding any discrepancies between physical count results versus system records.
- Verified accuracy of items picked, packed and shipped to customers.
- Selected products and items from shelves and pallets for customer orders.
- Labeled boxes and placed in outbound collection areas.
- Confirmed items picked for orders by keying codes into system.
- Maintained cleanliness of warehouse areas by sweeping floors, emptying trash cans and organizing shelves.
- Fulfilled orders quickly to accomplish challenging daily objectives.
- Placed products on conveyors for final wrapping and shipment.
Care Partner
Guthrie Robert Packer Hospital
Sayre, PA
01.2017 - 02.2019
- Maintained accurate records of patient care, condition, progress and concerns for review by medical staff.
- Completed registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements.
- Provided companionship and emotional support to elderly patients.
- Adhered to infection control guidelines while providing direct patient care services.
- Documented patient counters in hospital system and initiated follow-up actions.
- Reported concerns to nurse supervisor to promote optimal care.
- Transported patients to appointments or outings with wheelchair assistance.
- Responded promptly to emergency situations using appropriate interventions as required.
- Assisted with ambulation utilizing proper body mechanics techniques when transferring from bed, chair, wheelchair.
- Monitored vital signs and reported any changes to medical staff.
- Observed changes in behavior or physical condition that may indicate a need for intervention or adjustment in treatment plan.
- Maintained clean and well-organized environment for client happiness and safety.
- Followed safe lifting and transferring techniques to transport residents.
- Assisted in daily living activities such as bathing, dressing, grooming, and toileting.
Education
High School Diploma -
Northeast Bradford High School
Rome, PA06-2007
Skills
- Medical Coding
- Electronic Records Management
- Patient Insurance Authorizations
- Patient Scheduling
- Billing Procedures
- Understanding of Medical Terms
- Effective Communication Skills
- Records Maintenance
- Insurance Information Oversight
- Proficiency in Word, Excel, Powerpoint, HCPCS Codes, CPT codes, ICD 10 codes, Insurance websites,
- Medical Terminology
- Precertification Requirements
- Insurance Procedures
- Data Entry
Timeline
Prior Authorization Representative
Arnot Ogden Medical Center
11.2022 - Current
Picker
CVS Warehouse Distribution Center
04.2019 - 08.2022
Care Partner
Guthrie Robert Packer Hospital
01.2017 - 02.2019
High School Diploma -
Northeast Bradford High School
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