Rose Cates
Saint Petersburg
Summary
Dynamic Central Authorization Specialist with expertise in insurance verification and effective communication, previously at BayCare Health System. Proven track record in reducing authorization processing times and enhancing compliance, while training staff to improve team performance. Skilled in data entry and committed to delivering exceptional patient care through streamlined processes.
Overview
20
20
years of professional experience
Work History
Central Authorization Specialist
BayCare Health System Inc.
Saint Petersburg,FL
07.2008 - Current
- Communicated effectively with healthcare providers to verify patient eligibility and benefits.
- Processed insurance authorizations efficiently to ensure timely patient care.
- Reviewed clinical documentation for accuracy and completeness in support of authorization requests.
- Collaborated with interdisciplinary teams to resolve complex authorization issues promptly.
- Trained new staff on authorization protocols and system navigation for improved team performance.
- Analyzed authorization trends to identify areas for process improvement and efficiency gains.
- Implemented best practices that enhanced compliance and reduced denial rates in authorizations.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
Operations Manager
Bayfront Woundcare
Saint Petersburg, Fl
03.2006 - 06.2008
- Streamlined operational processes to enhance patient care efficiency and reduce wait times.
- Led cross-functional teams to implement best practices in wound care management.
- Developed training programs for staff to improve compliance with safety protocols and quality standards.
- Analyzed performance metrics to identify areas for process improvement and cost reduction.
- Coordinated supply chain logistics, ensuring timely availability of medical supplies and equipment.
- Implemented technology solutions to automate administrative tasks, increasing overall productivity.
- Supervised operations staff and kept employees compliant with company policies and procedures.
- Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.
- Conducted regular performance reviews, identifying areas for improvement and developing action plans to address them.
- Led hiring, onboarding and training of new hires to fulfill business requirements.
- Enhanced customer satisfaction by establishing clear communication channels and addressing concerns promptly.
- Analyzed and reported on key performance metrics to senior management.
Education
MBA - Business Administration And Management
South University Savannah
GA09.2023
Bachelor of Arts - Organizational Leadership
St. Petersburg College
Clearwater, FL05.2022
Associate of Science - Health Administration
St. Petersburg College
Clearwater, FL05.2020
Skills
- Medical terminology expertise
- Claims management
- Insurance verification
- Data entry proficiency
- Prior authorization processing
- HIPAA compliance
- Appointment scheduling
- Documentation and paperwork
- Documentation and reporting
- Microsoft office
- Effective communication skills
- Policy interpretation
- Application review
- Government relations
- Interviewing
- Resource information
- Knowledgeable in [software]
- Proficiency in [software]
- Verbal communication
- Data entry
- Record keeping
- Telephone etiquette
- Benefits administration
- Confidentiality
- Eligibility procedures
- Application assessment
- Income verification
- Advocacy and counseling
- Proficient in [language]
- Document processing
Timeline
Central Authorization Specialist
BayCare Health System Inc.
07.2008 - Current
Operations Manager
Bayfront Woundcare
03.2006 - 06.2008
MBA - Business Administration And Management
South University Savannah
Bachelor of Arts - Organizational Leadership
St. Petersburg College
Associate of Science - Health Administration
St. Petersburg College