Shannon Jordan
Summary
Diligent intake coordinator with solid background in insurance verification and proven track record of ensuring accurate and efficient processing of patient information. Successfully identified discrepancies and facilitated resolutions to improve workflow and reduce claim denials. Demonstrated expertise in communication and problem-solving.
Overview
12
12
years of professional experience
Work History
Insurance Verification Specialist
Baylor Scott & White Health
09.2022 - Current
- Liaison between insurance company providers office to ensure patient authorization for procedure is completed in a timely manner.
- Assisted in training new employees on best practices for efficient insurance verification processes and procedures.
- Experienced in utilizing insurance verification software
- Assisting special team for TMJ and dental surgery authorizations.
- Provide excellent verbal written communication skills to interact with insurances and healthcare staff.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Financial Service Intake Rep
AIS HealthCare
05.2022 - 09.2022
- Provided accurate insurance verification for clients, ensuring proper coverage was in place prior to service delivery.
- Identify in network or mandated pharmacy providers if unable to service a patient due to insurance constraints.
- Provided accurate insurance verification for clients, ensuring proper coverage was in place prior to service delivery.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Answered phone calls and messages for 50 plus physicians handling patient inquiries.
Intake Coordinator
KabaFusion
11.2021 - 05.2022
- Initiates intake process by contacting patients prior to start of care to confirm information, notification of financial obligation and arrange any requests for payment.
- Verifies insurance eligibility and benefits.
- Obtains authorizations for services.
- Maintain account documentation of patient information and communication with referral sources.
- Established rapport with patients through empathetic listening skills and providing relevant information regarding their care plans.
- Improved efficiency within the department by prioritizing tasks and managing time effectively.
- Resolved issues related to insurance authorizations or medical necessity quickly, minimizing delays in service provision.
Inside Sales Representative
Senderra RX Pharmacy
03.2020 - 10.2021
- Liaison between doctor's offices and our Sales Representatives in the field.
- Record thorough and accurate patient notes in their profiles for every call.
- Answer inbound calls in a timely manner and follow company procedures to answer questions and/or resolve issues.
- Compose and send patient status reports to physicians throughout the care process of the patient.
- Assist in streamlining communication with the patient, insurance companies, pharmacists, nurses, labs and other healthcare related practices.
- Coordinate responses and resolutions with the appropriate internal and external parties.
- Perform all tasks in a safe manner that is consistent with corporate policies as state and federal laws.
- Available to answer any calls from doctor's offices with any concerns that they may have.
Prior Authorization Specialist
Senderra RX Pharmacy
08.2017 - 03.2021
- Submit Team Initiate Authorization requests for output and input services in keeping with the prior authorization queue.
- Research claim inquiry specific to the department and responsibility.
- Perform tasks necessary to promote member compliance.
- Screen for eligibility and benefits.
- Construct letters of medical necessity to appeal the prior authorization once the patient has been denied services.
- Follow up Team Follow up on all claims requiring authorization.
- Send all updates and forms to physician and payer for necessary completion.
- Reviews proprietary software for workflow and tracking of open prior authorizations, appeals, and expiration.
- Assisted managerial staff with completing QR review for my team.
Occp
DaVita Rx Pharmacy
05.2016 - 07.2017
- Assisted patients with providing and setting up payment arrangements for accounts that were delinquent.
- Provided patients with order information in regards to their medication.
- Examined shipment contents and compared with records, such as manifests, invoices, or orders, to verify accuracy.
- Followed up with patients when concerning any issues with their medications.
- Conferred and corresponded with establishment representatives to rectify problems, such as damages, shortages, or nonconformance to specifications.
Customer Service Representative
DaVita Rx
12.2014 - 05.2016
- Assist patients with processing of their medications.
- Assist patients with tracking their shipments.
- Respond professionally and knowledgeably in accordance with company standards and other verbal and written training policies to patient inquiries with information regarding benefit plans (co-payments, deductibles, quantity and day supply limitations, etc.) and to other calls from clinics, insurance companies, pharmacies and physicians.
- Monitor record and communicate calls as appropriate using computerized documentation systems.
Pharmacy Benefit Manager
Optum Rx
10.2013 - 11.2014
- Process and ensure patients received paid prescription claims.
- Act as an intermediary between the payer and their prescription drug plan.
- Assist patients with any override and prior authorization status.
Education
High School Diploma -
Skyline High School
Dallas, TX05.2005
Skills
- Intake Experience
- Documentation review
- Medical Office Experience
- Computer skills
- Home health
- EMR Systems
- Medical Records
- Insurance Verification
- HIPAA compliance
- Detail orientation
- Problem solving
- Referral coordination
Timeline
Insurance Verification Specialist
Baylor Scott & White Health
09.2022 - Current
Financial Service Intake Rep
AIS HealthCare
05.2022 - 09.2022
Intake Coordinator
KabaFusion
11.2021 - 05.2022
Inside Sales Representative
Senderra RX Pharmacy
03.2020 - 10.2021
Prior Authorization Specialist
Senderra RX Pharmacy
08.2017 - 03.2021
Occp
DaVita Rx Pharmacy
05.2016 - 07.2017
Customer Service Representative
DaVita Rx
12.2014 - 05.2016
Pharmacy Benefit Manager
Optum Rx
10.2013 - 11.2014
High School Diploma -
Skyline High School
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