Summary
Overview
Work History
Education
Skills
Timeline
Generic

Rashaunda Cottrell

Royse City

Summary

Healthcare professional with specialization in pre-authorization coordination and compliance at Froedtert Health. Expertise in CPT, HCPCS, and ICD coding, successfully resolving complex authorization challenges. Improved operational efficiency while ensuring compliance with CMS and HIPAA standards.

Overview

21
21
years of professional experience

Work History

Pre-Authorization Coordinator

Froedtert Health
Milwaukee
01.2016 - Current
  • Receive, review, and process prior authorization requests within company and regulatory guidelines.
  • Ensure accuracy and completeness of supporting documents, including CPT, HCPCS, and ICD codes.
  • Prepare documentation supporting medical necessity for expedited approvals.
  • Collaborate with departments to resolve denials and submit appeals.
  • Maintain HIPAA compliance while safeguarding patient data.
  • Document all authorization details including dates, procedure codes, and approval numbers.

Insurance Authorization/Verification Specialist

Aurora Health Care
Milwaukee
01.2015 - 01.2016
  • Verified insurance eligibility, obtained pre-certifications, and coordinated peer-to-peer reviews.
  • Educated providers and staff on payer guidelines, coverage limits, and documentation requirements.
  • Managed appeals and resolved denied authorizations.

Member Services Representative

Common Ground Health Care
Brookfield
01.2014 - 01.2015
  • Handled provider and member inquiries regarding benefits, referrals, and authorizations.
  • Educated providers on prior authorization processes and outpatient service requirements.
  • Maintained detailed records in CRM systems.

Claims Repricing Specialist

Health Payment Systems
Milwaukee
01.2012 - 01.2014
  • Repriced medical claims in accordance with contractual agreements.
  • Resolved disputes with insurance companies, providers, and members.
  • Coordinated with repricing vendors to ensure accuracy.

Provider Services Representative

Centene (Texas Medicaid)
San Antonio
01.2012 - 12.2012
  • Responded to provider inquiries regarding claims, eligibility, and authorizations.
  • Ensured accurate documentation in CRM systems and first-call resolution.

Quality Auditor I

Blue Cross Blue Shield of WI
Milwaukee
01.2008 - 01.2012
  • Conducted audits on claims processing for compliance with regulations.
  • Prepared and presented audit findings to management.
  • Implemented corrective actions and continuous monitoring for compliance.

Claims Adjuster / Examiner / Processor

Blue Cross Blue Shield of WI
Milwaukee
01.2005 - 01.2008
  • Processed Medicare and other claim types.
  • Resolved billing adjustment requests, researched errors, and ensured compliance with CMS/HIPAA rules.

Education

Bachelor of Science - Healthcare Administration

Herzing University
Milwaukee, WI
05-2026

Skills

  • Healthcare fraud analysis
  • Quality assurance review
  • Case documentation and reporting
  • Microsoft Office proficiency
  • Database and internet research
  • CMS and HIPAA compliance
  • Medicare and Medicaid policies
  • Payer authorization knowledge
  • CPT, HCPCS, and ICD coding
  • Musculoskeletal anatomy expertise
  • Clinical terminology proficiency
  • Effective communication skills
  • Legal support services

Timeline

Pre-Authorization Coordinator

Froedtert Health
01.2016 - Current

Insurance Authorization/Verification Specialist

Aurora Health Care
01.2015 - 01.2016

Member Services Representative

Common Ground Health Care
01.2014 - 01.2015

Claims Repricing Specialist

Health Payment Systems
01.2012 - 01.2014

Provider Services Representative

Centene (Texas Medicaid)
01.2012 - 12.2012

Quality Auditor I

Blue Cross Blue Shield of WI
01.2008 - 01.2012

Claims Adjuster / Examiner / Processor

Blue Cross Blue Shield of WI
01.2005 - 01.2008

Bachelor of Science - Healthcare Administration

Herzing University

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