Summary
Overview
Work History
Education
Skills
Timeline
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Sherkera Lynch

Norfolk,United States

Summary

Dedicated administrative professional well-versed in communication, written skills, call center experience and team building. Knowledgeable in medical terminology, scheduling, prior authorization, program coordination, and UM Review. Equipped to bring years of relevant work experience to a team oriented environment.

Overview

6
6
years of professional experience

Work History

Program Coordinator

Accede Solutions
05.2023 - 05.2024
  • Develops and oversees programs, ensuring alignment with company goals and budget adherence.
  • Manages administrative tasks and provides planning support for international sales events.
  • Coordinates award and speaking engagements for top customers, enhancing client relationships.
  • Creates collateral and tracks top customers, contributing to international region growth.
  • Executes high-profile sales calls and visits, ensuring successful event outcomes.
  • Meticulously review physician letters, translating complex medical terminology into accessible language for mental health patients.

Utilization Review Specialist

Anthem
09.2022 - 05.2023
  • Maintained accurate records of medical service authorizations, ensuring compliance with regulations.
  • Communicated feedback on denials and approvals to provider staff, enhancing process transparency.
  • Performed utilization reviews for inpatient and outpatient services, ensuring medical necessity and appropriate care.
  • Researched complex cases with multiple diagnoses, providing thorough analysis and accurate documentation.
  • Coordinated appeals process among providers, members, and payers, facilitating resolution of denied requests.

Prior Authorization Specialist

Randstad
11.2021 - 04.2022
  • Monitored prior authorization requests via EHR, phone, and fax, ensuring timely processing.
  • Processed referrals and submitted medical records to expedite authorizations, improving approval.
  • Managed correspondence with insurance companies, physicians, and patients, maintaining accurate EHR documentation.
  • Assisted with medical necessity documentation, facilitating quicker approvals and consistent follow-ups.
  • Reviewed information accuracy and completeness, ensuring all supporting documents were present.
  • Followed up on denials with providers, securing necessary information for successful appeals.
  • Prioritized authorizations by urgency, enhancing patient care and satisfaction.

Customer Care Coordinator

First Transit
05.2019 - 01.2020
  • Provided excellent customer service, resolving inquiries and complaints in a timely manner
  • Used computerized systems for tracking, information gathering, and troubleshooting
  • Maintained confidentiality of customer records at all times in accordance with company policies
  • Performed administrative tasks such as preparing documents, entering data into the system
  • Gathered and verified all required customer information for tracking purposes
  • Monitored customer accounts to ensure compliance with company policies and procedures.

Member Services Representative

QVC Call Center
09.2018 - 05.2019
  • Demonstrated expertise in customer service, resolving complex inquiries, and problem solving
  • Navigated multiple computer systems and applications and utilized search tools to find information
  • Monitored member accounts for fraudulent activities
  • Answered inquiries and provided information to members regarding services and products
  • Maintained accurate records of member activity in a timely manner for compliance purposes
  • Ensured compliance with applicable laws and regulations related to
  • Provided exceptional customer service to clients in fast-paced call center environment.

Education

High School -

Matthew Fontaine Maury High School
Norfolk, VA
01.2016

Skills

  • Call Center Experience
  • Communication Skills
  • Oral written communication
  • Time Management
  • Adaptability
  • Active listening
  • Team Work
  • Excel
  • Power point
  • Typing
  • Microsoft teams

Timeline

Program Coordinator

Accede Solutions
05.2023 - 05.2024

Utilization Review Specialist

Anthem
09.2022 - 05.2023

Prior Authorization Specialist

Randstad
11.2021 - 04.2022

Customer Care Coordinator

First Transit
05.2019 - 01.2020

Member Services Representative

QVC Call Center
09.2018 - 05.2019

High School -

Matthew Fontaine Maury High School

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Sherkera Lynch