Summary
Overview
Work History
Education
Skills
Timeline
Generic

Monyea Manning

TX

Summary

Certified Medical Assistant with over 9 years of experience in dermatology, plastic surgery, and specialty pharmacy settings. Proven expertise in prior authorizations, insurance verification, benefits investigation, and coordinating biologic therapies. Skilled in managing appeals and following up with payers to ensure timely patient access to prescribed treatments. Adept at navigating complex insurance policies, EMR systems, and specialty pharmacy workflows while maintaining a patient-centered approach. Strong communicator and problem-solver with a track record of streamlining access to care and supporting clinical teams in fast-paced environments.

Overview

9
9
years of professional experience

Work History

Prior Authorization Specialist

Blue Sky Specialty Pharmacy
10.2024 - 06.2025
  • Reviewed and processed prior authorization requests to ensure compliance with insurance guidelines.
  • Collaborated with healthcare providers to obtain necessary documentation for authorization approvals.
  • Educated staff on policy changes impacting prior authorization procedures and requirements.
  • Analyzed denial trends and developed strategies to improve approval rates for authorizations.
  • Streamlined processes, reducing turnaround times for authorization decisions significantly.
  • Led initiatives to enhance communication between departments regarding authorization status updates.
  • Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Enhanced communication between healthcare providers and insurance companies, ensuring prompt resolution of issues related to prior authorizations.

Certified Medical Assistant/Biologic Coordinator

Advanced Dermatology
07.2024 - 10.2024
  • Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
  • Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
  • Analyzed medical records and other documents to determine approval of requests for authorization.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Responded to inquiries from healthcare providers regarding prior authorization requests.
  • Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
  • Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
  • Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
  • Assisted in troubleshooting complex issues within the biologics process, contributing to swift resolutions and minimal downtime.
  • Established strong working relationships with vendors and suppliers to secure high-quality materials at competitive prices.
  • Identified opportunities for cost savings in the biologics production process, leading to reduced overhead expenses without compromising quality.
  • Enhanced biologics processing by implementing innovative techniques and procedures.
  • Utilized electronic health record systems to track and manage authorization workflows efficiently.

Certified Medical Assistant/Biologic Coordinator

Sanova Dermatology
11.2021 - 07.2024
  • Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
  • Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
  • Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
  • Improved patient experiences by efficiently managing appointments and maintaining organized medical records.
  • Contributed to positive health outcomes by educating patients on preventative measures, treatment plans, and follow-up care instructions.
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
  • Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
  • Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
  • Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.

Certified Clinical Medical Assistant

Clear Dermatology
08.2016 - 11.2021
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
  • Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
  • Aided in accurate diagnoses by performing laboratory tests and preparing specimens for analysis.
  • Streamlined office operations by managing inventory levels, ordering supplies, and organizing storage areas.
  • Reduced wait times by swiftly processing insurance claims, verifying coverage, and obtaining pre-authorizations when necessary.
  • Coordinated sample transfers between departments for analysis or further processing.
  • Tracked referral submission during facilitation of prior authorization issuance.
  • Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
  • Managed medical records using electronic health record systems to maintain accurate patient information.
  • Administered patient care and assisted with examinations to ensure optimal comfort and support.

Education

Medical Assisting Certificate -

Pima Medical Institute
01-2015

Associate of Science - Nursing

Texas Southern University
01-2016

High School Diploma -

Andress High School
01-2013

Skills

  • HIPAA Compliance
  • Customer Service
  • Medical terminology knowledge
  • Vital Sign Monitoring
  • Clinical Documentation
  • Data Entry
  • Patient Management
  • Patient Relations
  • Medical billing and coding
  • Clinical documentation
  • Electronic health records
  • Time management

Timeline

Prior Authorization Specialist

Blue Sky Specialty Pharmacy
10.2024 - 06.2025

Certified Medical Assistant/Biologic Coordinator

Advanced Dermatology
07.2024 - 10.2024

Certified Medical Assistant/Biologic Coordinator

Sanova Dermatology
11.2021 - 07.2024

Certified Clinical Medical Assistant

Clear Dermatology
08.2016 - 11.2021

Medical Assisting Certificate -

Pima Medical Institute

Associate of Science - Nursing

Texas Southern University

High School Diploma -

Andress High School

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