Shanika Brown
Marietta,Georgia
Summary
Highly motivated and committed Concierge Medical Authorization Supervisor with a proven history of superior performance at the individual, team, and organizational levels. Strong ability to multitask and prioritize workloads with no supervision. Detail-oriented professional looking to bring medical background and team building skills to a reputable company to contribute many years of experience, a proactive attitude, and a positive atmosphere to foster exceptional service to ensure quality patient centered care.
Overview
25
25
years of professional experience
Work History
Concierge Medical Authorization Supervisor
Royal Health Inc.
06.2020 - Current
- Leading and supervising a team of 22 medical authorization specialists, assigning tasks, coaching performance, and addressing issues related to authorization requests.
- Ensuring accurate and timely processing of patient insurance pre-authorizations by monitoring workflows, training staff, resolving complex cases, and maintaining compliance with healthcare regulations, all while upholding quality standards and meeting performance metrics within a healthcare organization.
- Providing ongoing training to staff on new insurance regulations, coding updates, and internal processes related to medical authorizations for diagnostic imaging including mri, ct scan, ultrasound, x-rays, nuclear medicine, cardiac, and interventional radiology scans.
- Monitoring compliance with HIPAA regulations, payer contracts, and other relevant healthcare laws regarding patient information and authorization procedures.
- Tracking key performance indicators like authorization turnaround times, denial rates, productivity metrics to identify areas for improvement, and yearly performance evaluations.
- Maintaining relationships with clients, insurance companies, understanding their authorization requirements, and advocating for patient needs.
- Provide accurate and timely management of timecards for payroll.
Authorization/Referral Team Lead/Patient Care Coordinator
Akumin/DPI
09.2010 - 06.2020
- Provide initial and follow-up training to team members.
- Oversee the policies, processes, and employees within the auth/referral department.
- Plan and schedule work for the unit to ensure proper staffing and distribution of assignments to accomplish required tasks, Coordinated and participated in the maintenance of various files, logs, and records to ensure completeness of patient information.
- Make sure diagnostic exams are scheduled correctly, call patients with concerns, train employees with all new systems such as Royal, RIS, verify insurance benefits and request authorizations, make sure all task on list are completed and assure there are no mistakes.
Medical Clerk Supervisor/Medical Asst.
Glades Medical Group
01.2000 - 08.2010
- Accountable for day-to-day patient check-in, scheduling, and registering patients, including accurately obtaining new patient information and updating existing patient information.
- Obtain insurance verification and/or medical authorization via computer usage or phone.
- Collect co-pays and deductibles, Ability to function during computer downtime procedures as required by the department, Ability to remain calm and professional in emergency situations.
Education
Medical Assistant
Concorde Career Institute
Lauderdale Lakes, FL01.1997
Skills
- Comprehensive understanding of medical billing codes, insurance verification, and different payer types
- Knowledge of medical terminology and disease processes to interpret patient records for authorization needs
- Proven ability to motivate, delegate tasks, and provide effective feedback to team members
- Excellent verbal and written communication to interact with patients, clients, providers, and insurance companies
- Experience with electronic health records systems and medical authorization software including Ris, Mitel, Fuji, Webex, Fast Auth, and Intellipath
Timeline
Concierge Medical Authorization Supervisor
Royal Health Inc.
06.2020 - Current
Authorization/Referral Team Lead/Patient Care Coordinator
Akumin/DPI
09.2010 - 06.2020
Medical Clerk Supervisor/Medical Asst.
Glades Medical Group
01.2000 - 08.2010
Medical Assistant
Concorde Career Institute
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