Samantha Majors
Mount Washington ,KY
Summary
Dynamic professional with extensive experience at Norton Healthcare, excelling in authorization processes and ICD-10 coding. Proven ability to enhance workflow management and ensure data entry accuracy. Recognized for effective communication and attention to detail, consistently delivering exceptional service while navigating complex insurance verification challenges.
Overview
11
11
years of professional experience
Work History
Pre-service Representative
Norton Healthcare
LOUISVILLE, KY
08.2019 - Current
- Monitored compliance with regulations concerning authorization processes.
- Managed workflow processes for authorization requests, including routing documents and tracking progress.
- Reviewed and approved authorization requests according to established criteria.
- Evaluated current policies and procedures related to authorizing services or products, making changes where appropriate.
- Coordinated communication between departments regarding authorization procedures.
- Created detailed documentation of processes related to authorizing services and products.
- Entered data into electronic medical record system accurately and efficiently.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Reviewed authorization requests for accuracy and completeness.
- Tracked authorization statuses using electronic databases or manual filing systems.
- The pre service representative utilizes multiple systems simultaneously and works in a fast paced, productivity driven call center environment accepting inbound calls promptly and making outbound calls in a professional and courteous manner and independently works to resolve patient and provider questions related to referrals, pre-authorizations, and insurance verification. The representative possesses strong telephone communication and computer skills, problem-solving abilities, and demonstrates the highest level of customer service for all patients, providers, and other team members.
- Using specific ICD- 10/ CPT codes to authorize testing.
Authorization Specialist
Kaplan Barron Pediatric Group
LOUISVILLE, KY
01.2015 - 08.2019
- Researched insurance coverage details for patients to determine authorization requirements.
- Processed electronic authorizations in accordance with established policies and procedures.
- Provided customer service support to patients regarding their authorization inquiries.
- Calling insurance companies to submit authorizations/ check requirements for patients.
- Using specific ICD-10 CODES/ CPT codes to approve testing.
Education
High School Diploma -
PLEASURE RIDGE PARK HIGH SCHOOL
Louisville, KY06-2011
Skills
- Authorization processes
- ICD-10 coding
- Data entry accuracy
- Workflow management
- Effective communication
- Attention to detail
- Adaptability to change
- Insurance verification
- Medical terminology
- Eligibility determination
Timeline
Pre-service Representative
Norton Healthcare
08.2019 - Current
Authorization Specialist
Kaplan Barron Pediatric Group
01.2015 - 08.2019
High School Diploma -
PLEASURE RIDGE PARK HIGH SCHOOL
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