Nyssa R. Lam
Farmington
Summary
Experienced Authorization Specialist with a proven track record of over 4 years in fast-paced, clinical environments. Skilled in efficiently navigating complex authorization processes and ensuring timely approvals. Adept at collaborating with healthcare professionals and insurance providers to optimize patient care. Committed to maintaining accuracy and attention to detail while meeting strict deadlines.
Overview
11
11
years of professional experience
Work History
Authorization Specialist
Reliable Respiratory
06.2023 - Current
- Review all active Diabetes Medicare rentals and future claims to ensure proper documentation on hand for on-time billing.
- Prepare and submit prior authorizations to various commercial insurance plans.
- Review and ensure patient eligibility requirements are met for successful payment of claims.
- Request and review medical documentation including office visit notes, prescriptions, and other forms as needed.
- Fielded telephone inquiries on authorization details from patients, insurance representatives, and medical staff.
- Researched denied PARs and contacted insurance companies to resolve issues when applicable.
Sales & Account Representative
ML Marketing LLC
07.2022 - 06.2023
- Provided excellent customer care and support to various clients with a minimum outbound calls of 50 per day.
- Utilized a comprehensive database to contact clients and perform data entry tasks.
- Experienced with direct sales as well as cold calling and contracting new customers.
- Increased customer satisfaction ratings through proactive and actionable resolutions to questions, concerns, or challenges.
- Kept detailed records of customer interactions for optimal traceability.
- Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
Receptionist
Grosso Chiropractic P.C.
11.2018 - 01.2021
- Maintained confidentiality of information regarding patient information.
- Answered phone promptly and directed incoming calls to correct offices.
- Corresponded with clients through email, telephone, or postal mail.
- Managed multiple tasks and met time-sensitive deadlines.
- Kept reception area clean and neat to give visitors positive first impression.
- Confirmed appointments, communicated with clients, and updated client records.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Provided clerical support by copying, faxing, and filing documents.
- Handled cash transactions and maintained sales and payments records accurately.
- Handled assignments independently with good judgement and critical thinking skills.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Completed physical inventory counts each month.
- Verified orders by comparing names and quantity of items packaged with shipping documents.
- Monitored inventory to maintain sufficient supply levels to meet business and customer needs.
Health and Safety Educator/Owner
WestSide IMPACT
08.2014 - 01.2021
- Company Overview: Service-based business providing certification in CPR/AED, Basic First Aid, BBP, and Basic Life Support.
- Certified AED salesperson.
- RSV (Remote Skills Verification) approved instructor with the ability to provide remote training within OSHA and AHA guidelines.
- Collaborated with adults and children to provide safe and educational experience.
- Chose materials and developed lesson plans to enhance skills for individual students.
- Managed day-to-day business operations.
- Interacted well with customers to build connections and nurture relationships.
- Developed strong communication and organizational skills through providing large group trainings.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
Pharmacy Technician
CVS Health
11.2016 - 02.2018
- Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
- Entered and processed patients' prescriptions into internal system.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Collected co-payments or full payments from customers.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
Education
A.S. - Health Care Administration
CT State Community College At Middlesex
Middletown, CT05-2026
Skills
- Proven Customer Support Skills
- Excellent Written and Oral communications
- Time Management and Prioritization
- Exemplary Ability to Multitask High Priority Tasks and Objectives
- Distinguished Problem Solving and Team Collaboration
- Excellent Medical Insurance and Medicare Knowledge and Experience
- Strong Analytical Ability to Determine Discrepancies and Errors
- Prior authorization processing
- Insurance verification
- Proficiency in Brightree
- Proficiency in Microsoft 365 Suite
Timeline
Authorization Specialist
Reliable Respiratory
06.2023 - Current
Sales & Account Representative
ML Marketing LLC
07.2022 - 06.2023
Receptionist
Grosso Chiropractic P.C.
11.2018 - 01.2021
Pharmacy Technician
CVS Health
11.2016 - 02.2018
Health and Safety Educator/Owner
WestSide IMPACT
08.2014 - 01.2021
A.S. - Health Care Administration
CT State Community College At Middlesex
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