Phoenix Shakespeare
Boise,ID
Summary
Detailed Prior Authorization Specialist with a deep understanding of insurance requirements, benefit verification, and medication access. Proficient in utilizing platforms such as Epic, CoverMyMeds, and various payer-specific portals to secure timely authorizations for a wide range of therapies. Brings a strong pharmacy foundation with hands-on experience across outpatient, inpatient, and specialty settings, including oncology and hospital-based care.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
St. Luke's Health System
08.2024 - Current
- Reviewed and processed prior authorization requests for medications and procedures by verifying insurance coverage, clinical documentation, and payer specific criteria.
- Collaborated with providers, pharmacists, and insurance representatives to secure timely approvals and minimize treatment delays.
- Utilized platforms such as Epic, CoverMyMeds, and payer portals to submit and track authorization requests efficiently.
- Maintained up to date knowledge of insurance formularies, prior authorization requirements, and evolving policy changes.
Project Coordinator
Floform Countertops
07.2021 - 07.2024
- Managed residential renovation projects by working effectively with general contractors, subcontractors, and clients.
- Adapted to shifting timelines, delays, and unexpected project changes with professionalism and flexibility.
- Identified process improvements and introduced creative solutions to reduce delays, and keep renovation projects moving forward efficiently.
Education
BBA - Management
Boise State University
Boise, ID05-2026
Skills
- Patient referrals
- Data entry
- HIPAA compliance
- Willow Ambulatory
- EPIC
Certification
Certified Pharmacy Technician
Timeline
Prior Authorization Specialist
St. Luke's Health System
08.2024 - Current
Project Coordinator
Floform Countertops
07.2021 - 07.2024
BBA - Management
Boise State University
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