RaDaun Gleave
St. George
Summary
Hardworking Prior Authorization Specialist with expertise in medical terminology and insurance verification at Red Rock Canyon School & Never Give Up Youth. Proven ability to analyze medical records and ensure compliance with HIPAA regulations, enhancing patient care. Skilled in relationship building and documentation review, delivering accurate and timely authorization outcomes.
Overview
14
14
years of professional experience
Work History
Stay at Home Mom
Self
03.2020 - 03.2025
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
Prior Authorization Specialist
Never Give Up Youth
07.2018 - 03.2020
- 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 medicaCol records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
Secretary
Red Rock Canyon School
08.2011 - 05.2018
- Handled sensitive information discreetly, maintaining confidentiality when managing personnel files or financial data.
- Answered multi-line phone system and enthusiastically greeted callers.
- Maintained daily report documents.
- Scheduled appointments and conducted follow-up calls to clients.
Education
High School Diploma -
Richfield High School
Richfield, UT05-2020
Skills
- Prior authorization process
- Medical terminology
- Medical appeals handling
- Insurance verification
- Time management
- Patient care
- Attention to detail
- HIPAA compliance
- Basic Life Support
- Database management
- Relationship building and management
- Documentation review
Timeline
Stay at Home Mom
Self
03.2020 - 03.2025
Prior Authorization Specialist
Never Give Up Youth
07.2018 - 03.2020
Secretary
Red Rock Canyon School
08.2011 - 05.2018
High School Diploma -
Richfield High School
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