NICHOLE HOWARD
Indianapolis,IN
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 13 years of managing documentation. Considered team player with exemplary multitasking skills.
Overview
21
21
years of professional experience
Work History
Prior Authorization Representative
Hopebridge Autism Therapy Center
05.2023 - Current
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Verified eligibility and compliance with authorization requirements for service providers.
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Processed new medication and refill requests for authorization.
- Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.
- Collaborated with healthcare providers to expedite the process of obtaining necessary medical documentation for approvals.
- Contributed to departmental success by consistently meeting or exceeding performance metrics such as accuracy, productivity, and quality standards.
PRIOR AUTHORIZATION TECH
MDwise
11.2014 - 05.2023
- Initial Request: Initiate the Prior Authorization Process
- Process request's in a timely manner have meet and exceed all established performance standards, including meeting state requirements and MDwise goals.
- Coordinated with care management teams to assess and address patient needs holistically, contributing to overall health outcomes improvement.
- I demonstrate knowledge to perform essential duties and functions of the job
- I display job related knowledge, skills and education learned in training.
- Verified eligibility and compliance with authorization requirements for service providers.
- Tracked referral submission during facilitation of prior authorization issuance.
CUSTOMER SERVICE
Speedway
07.2012 - 08.2014
- Lead cashier for 3rd shift
- Counting my drawer down at the end of my shift.
- Provided excellent customer service, addressing any concerns or inquiries promptly.
CUSTOMER SERVICE SUPERVISOR
Longview Communications
08.2003 - 04.2009
- Supervised 10 customer service reps, monitored calls weekly , processed payments via online, I had taken all supervisor calls from irate customers.
- Processed online orders for cable t.v
- Responsible for calling the customers about interruption in service due to delinquent account for non payment.
- Improved customer satisfaction by addressing and resolving escalated issues promptly and professionally.
- Promoted a positive work environment through open communication channels, fostering team collaboration and high morale.
- Collaborated with other departments to address recurring customer concerns, improving overall service quality.
- Coached employees through day-to-day work and complex problems.
Education
Completed coursework towards D.S.Sc. Social Work -
IUPUI
Indianapolis, IN12.2001
Skills
- Microsoft Excel
- Jiva
- Microsoft Word
- Office
- Communication Skills
- Basic medical terminology
- Benefit Coverage
- HIPAA Compliance
- Healthcare Industry Knowledge
- Insurance Verification
- Insurance authorization
- Provider Relations
References
References available upon request
Timeline
Prior Authorization Representative
Hopebridge Autism Therapy Center
05.2023 - Current
PRIOR AUTHORIZATION TECH
MDwise
11.2014 - 05.2023
CUSTOMER SERVICE
Speedway
07.2012 - 08.2014
CUSTOMER SERVICE SUPERVISOR
Longview Communications
08.2003 - 04.2009
Completed coursework towards D.S.Sc. Social Work -
IUPUI
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