Nathaly Curtis
Shrewsbury,MA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
6
6
years of professional experience
Work History
Prior Authorization Specialist
Reliant Medical Group
01.2022 - Current
- Input all patient data regarding claims and prior authorizations into system accurately.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
Shift Manager
Starbucks
01.2020 - 12.2022
- Trained and mentored new employees to maximize team performance.
- Kept employees operating productively and working on task to meet business and customer needs.
- Supervised employees and oversaw quality compliance with company standards for food and services.
- Worked closely with team members to schedule breaks and shifts to meet state regulations.
- Cooperated with coworkers to improve customer experience and manage storefront.
- Excelled in every store position and regularly backed up front-line staff.
- Tracked receipts, employee hours, and inventory movements.
- Advised new employees on company procedures and policies to facilitate daily tasks and responsibilities.
- Scheduled staff to establish adequate coverage during peak business hours.
Education
Bachelor of Science - Health Administration
Regis College
Weston, MA07.2026
Skills
- Private Insurance
- Insurance Information Oversight
- Medical Terminology
- Medical Records Verification
- Referral Coordination
- Calendar and Appointment Management
- Data Integrity
- Computer Proficiency
- Records Preparation
- Microsoft Excel
- Reading Comprehension
- Managing Multiple Tasks
- Administrative Support
Timeline
Prior Authorization Specialist
Reliant Medical Group
01.2022 - Current
Shift Manager
Starbucks
01.2020 - 12.2022
Bachelor of Science - Health Administration
Regis College
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