Shampy Singh
Bellerose,NY
Summary
Results-driven Prior Authorization Specialist with a robust history at Alfa Health Care, excelling in insurance verification and optimizing authorization workflows through effective communication. Proven ability to train and mentor new staff, enhancing team performance and operational efficiency. Committed to maintaining high standards of professionalism and ethics while delivering exceptional support to patients and providers.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Alfa Health Care
Floral Park, New York
07.2020 - 08.2022
- Clarified patient inquiries and questions to update patient account information in computer system.+0
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.
- Maintained files for referral and insurance information, entering referrals into system.
- Maintained accurate records of all authorization activities in the database system.
- Analyzed trends in authorization denials and reported findings to management for quality improvement initiatives.
- Notified ordering providers of denied authorizations.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Assisted with developing policies and procedures related to prior authorizations.
- Reviewed and processed prior authorization requests for DME according to established guidelines.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Trained new staff on prior authorization procedures and company policies.
- Coordinated with doctor office staff to ensure DME requiring prior authorization are processed correctly.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Utilized medical coding knowledge to accurately process and document authorization requests.
- Provided customer service to patients and healthcare providers, answering questions related to prior authorization and insurance coverage.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for DME services.
Cashier
Apna Bazaar cash & carry
Floral Park, New York
04.2018 - 01.2020
- Issued receipts, refunds, credits or change due to customers.
- Collected payments and provided accurate change.
- Worked closely with front-end staff to assist customers.
- Answered customer inquiries regarding store policies and procedures.
- Maintained clean and orderly checkout areas by sanitizing register belts, emptying trash cans and organizing candy racks.
- Assisted customers over the phone regarding store operations, product information and order placement.
- Greeted customers promptly and responded to questions.
- Scanned items and checked pricing on cash register for accuracy.
- Processed returned merchandise by strictly following store return and exchange procedures.
- Counted money in cash drawers at the beginning of shifts to ensure amounts were correct.
- Performed opening and closing procedures including counting cash drawers and preparing deposits.
- Answered phone calls to assist customers with questions and orders.
- Performed other duties as assigned by management.
- Trained and mentored new cashiers to maximize performance with skilled, efficient and knowledgeable team members.
- Directed trash removal and sanitation procedures to keep aisles and register area organized.
Education
3 Yrs Diploma - Computer Science
Punjab Technical University
Punjab08-2012
High School Diploma -
Punjab School Education Board
Punjab08-2009
Skills
- Workflow management
- Professionalism and ethics
- Records maintenance
- Insurance verification
- Benefit coverage
- Effective communication skills
- ICD-10 coding
- Prior authorization process
- CPT coding
- Insurance procedures
- Medical terminology
Certification
- computer languages c,c++,java, c#, .net
- medical terminology
- anatomy and physiology
- icd-10 coding
Languages
English
Professional
Hindi
Professional
Punjabi
Professional
Urdu
Professional
Timeline
Prior Authorization Specialist
Alfa Health Care
07.2020 - 08.2022
Cashier
Apna Bazaar cash & carry
04.2018 - 01.2020
- computer languages c,c++,java, c#, .net
- medical terminology
- anatomy and physiology
- icd-10 coding
3 Yrs Diploma - Computer Science
Punjab Technical University
High School Diploma -
Punjab School Education Board
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