Megan Sidher
Summary
Efficient Authorization Specialist with comprehensive knowledge of medical insurance policies, coding and procedures. Demonstrated ability to liaise effectively between patients, healthcare providers, and insurance companies for smooth transactions. Strengths include strong problem-solving skills, thoroughness in documentation and a keen eye for identifying inconsistencies. Proven impact in previous roles includes streamlined authorization processes, improved satisfaction rates, and reduced claim denials.
Overview
4
4
years of professional experience
Work History
Clinical Authorization Specialist
Progyny Inc.
New York, USA
09.2022 - Current
- Verified insurance authorizations and benefits with providers via telephone or web-based systems.
- Investigated discrepancies identified by providers or members.
- Monitored daily workflow, ensuring all assigned tasks are completed accurately and timely.
- Forecasted clinic needs to support accurate and effective decision-making.
- Assist providers and members by approving allowed services, using my interpersonal skills while working with providers to come to a resolution.
- Conducted training sessions for new employees related to the provider portal.
- Provided provider knowledge to provide optimal service, and improve workflow.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Accounts Receivable
Gastroenterology Consultants
Reno, USA
10.2021 - 09.2022
- Worked closely with patients to discuss payment arrangements when needed.
- Managed payments from patients and insurance companies.
- Collected, posted and managed patient and provider account payments.
- Monitored accounts receivable balances and aging reports.
- Inspected accounts receivable and payable ledgers.
- Reconciled accounts receivable balances against customer payment histories.
- Researched and resolved discrepancies related to accounts receivable.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Monitored past due accounts and pursued collections on outstanding invoices.
Externship
Bristlecone Family Resources
Reno, USA
08.2021 - 09.2021
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Answered incoming calls in a professional manner and directed callers to the appropriate personnel.
- Maintained filing systems, both electronic and physical, for easy document retrieval.
- Assisted in the onboarding process for new patients.
- Verified insurance coverage and eligibility for medical services rendered.
- Input details into accounts and tracked payments.
- Assisted patients in understanding the details of their billings and payments.
- Submitted appeals to insurance companies when necessary.
- Maintained accurate records of claims processing in compliance with HIPAA regulations.
Education
Associate Degree - Occupational Studies in Health Information Management
Career College of Northern Nevada
09.2021
Skills
- Abstracting and analyzing data
- Communication Techniques
- Customer service
- De-escalation techniques
- Electronic Health Records
- Effective Communication
- Prior authorization processing
- Problem Solving
- Process improvement
- Proficient in Salesforce
- Proficient in Microsoft Office
- Project Management
- Telephone etiquette
- Workflow management
Timeline
Clinical Authorization Specialist
Progyny Inc.
09.2022 - Current
Accounts Receivable
Gastroenterology Consultants
10.2021 - 09.2022
Externship
Bristlecone Family Resources
08.2021 - 09.2021
Associate Degree - Occupational Studies in Health Information Management
Career College of Northern Nevada
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