Santanna Holman
Lake Charles,LA
Summary
With over 8 years of experience in healthcare support and prior authorization, I have a deep understanding of the complexities involved in managing pre-approvals and ensuring compliance with insurance requirements. My approach is both detail-oriented and compassionate, ensuring patients receive timely authorizations while adhering to regulatory guidelines. I excel in communicating with providers and payers, coordinating care, and streamlining processes to improve efficiency and patient satisfaction.
Overview
9
9
years of professional experience
Work History
Prior Authorization Specialist
Coordinated Care
11.2021 - 09.2024
- Processed and reviewed authorization requests, verifying insurance coverage and medical necessity to ensure compliance with payer requirements
- Collaborated closely with healthcare providers to gather necessary documentation and provide guidance on authorization procedures
- Utilized healthcare systems to track authorizations and maintain detailed patient records, ensuring accuracy and privacy compliance
- Implemented a new tracking system that reduced turnaround times for prior authorizations, leading to quicker access to necessary care
- Regularly commended by patients and providers for efficient handling of authorization requests and clear communication
Healthcare Authorization Coordinator
ResCare
06.2017 - 10.2021
- Coordinated prior authorization requests for a high-volume clinic, managing approvals and appeals in alignment with payer policies
- Developed and maintained relationships with insurance representatives to expedite the approval process and resolve issues promptly
- Provided training to new team members on authorization protocols and best practices, enhancing team efficiency and knowledge sharing
- Analyzed authorization data to identify trends and opportunities for process improvements, contributing to enhanced operational efficiency
- Created patient information packets to clarify the authorization process, which reduced patient callbacks and improved satisfaction
- Developed a patient-centered approach that resulted in consistently positive feedback from both patients and healthcare providers
Medical Billing Specialist
Gardiner Community Health Center
02.2016 - 05.2017
- Managed billing and insurance verification, processing claims and prior authorizations with accuracy and compliance
- Worked closely with providers to resolve discrepancies and ensure timely payment, minimizing delays in patient care
- Maintained meticulous records, supporting regulatory compliance and transparency in billing practices
- Played a key role in reducing denied claims by identifying common errors and providing feedback to improve documentation practices
- Participated in quality assurance initiatives, ensuring all documentation adhered to organizational standards and payer guidelines
Education
Allied Health - Medical Assistant
Remington College
Lafayette, LA03-2004
Skills
- Prior Authorization Management
- Healthcare Communication
- Physician order verification
- Patient Scheduling
- Provider Relations
- Prescription Coordination
- Insurance procedures
- Insurance Verification
- Data Management
- Process improvement strategies
- Training & Mentorship
- Compliance
Timeline
Prior Authorization Specialist
Coordinated Care
11.2021 - 09.2024
Healthcare Authorization Coordinator
ResCare
06.2017 - 10.2021
Medical Billing Specialist
Gardiner Community Health Center
02.2016 - 05.2017
Allied Health - Medical Assistant
Remington College
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