Experienced lead prior authorization specialist with expertise in insurance verification, referral management, and HIPAA-compliant workflows. Known for training staff, resolving authorization issues, and improving patient access through efficient coordination.
Overview
16
16
years of professional experience
Work History
Lead Prior Authorization Specialist
Marshall Healthcare
Huntington, West Virginia
02.2023 - Current
Ensured timely completion of all prior authorization requests.
Collaborated with insurance providers to resolve authorization issues promptly.
Educate healthcare providers on prior authorization requirements and insurance formulary changes.
Assist medical staff in simplifying authorization workflows and supporting patient care.
Collaborated with team to create policies and procedures for prior authorizations.
Trained new employees on department processes and procedures.
Follow procedures to support compliance with healthcare regulations and standards.
Maintained files for referral and insurance information, entering referrals into the system.
Office Manager
Marshall Health Orthopedics
Huntington, WV
06.2025 - 07.2025
Managed front office operations for Marshall Health Orthopedics patient flow.
Oversaw daily office functions, streamlining workflow and enhancing productivity.
Scheduled and confirmed patient appointments to optimize clinic schedule and reduce wait times.
Managed patient records and ensured timely communication regarding appointments and follow-ups.
Handled patient calls, messages, and appointment changes.
Facilitated communication among team members, improving collaboration and service delivery.
Enforced HIPAA compliance across administrative workflows.
Referral Coordinator
Cabell Huntington Hospital
Huntington, WV
12.2010 - 02.2023
Coordinated patient referrals across hospital departments and specialty clinics.
Verified referral details and insurance information for Cabell Huntington Hospital patients.
Scheduled specialist appointments using hospital scheduling systems and provider calendars.
Communicated with physicians, offices, and patients about referral status updates.
Reviewed medical records to support accurate referral processing and documentation.
Resolved referral questions with patients, staff, and outside provider offices.
Answered questions and resolved concerns raised by both patients and specialists.