Siby George
Authorization Specialist
Pembroke Pines,FL
Summary
Dynamic Authorization Representative II at Centene Corporation with expertise in electronic health records and HIPAA compliance. Proven ability to enhance authorization processes through meticulous documentation and effective communication. Recognized for training new staff and resolving complex issues, ensuring high standards of accuracy and customer service in a fast-paced healthcare environment.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Authorization Representative II
Centene Corporation
Pembroke Pines, FL
11.2020 - Current
- Facilitated authorization requests for medical services and procedures efficiently.
- Audited documentation for accuracy and compliance with company guidelines.
- Collaborated with healthcare providers to elucidate patient information and requirements.
- Administered electronic health record systems in tracking and coordinating authorizations.
- Collaborated with team members to address authorization issues swiftly.
- Educated new staff on authorization processes and company policies comprehensively.
- Documented authorization requests and outcomes with precision
- Ensured adherence to HIPAA regulations during handling of confidential patient information.
- Collaborated on special projects as specified by management.
- Audited and confirmed patient information to guarantee accuracy of insurance authorizations.
- Monitored adherence to departmental standards and performance expectations.
- Updated knowledge of applicable laws, regulations, and guidelines governing health plan operations.
- Executed electronic authorizations in alignment with established policies and procedures.
- Resolved customer concerns via timely telephone and written interactions
- Executed quality evaluations on projects finalized by team members.
- Facilitated escalation of complex cases when necessary following established protocols.
- Facilitated training sessions for new hires on relevant policies and procedures.
- Established, monitored, and upheld precise records of all authorization requests.
- Evaluated required resources to ensure successful software conversion and validation improvement.
Lab Tech Assistant
Menorah Medical Center
Overland Park, KS
06.2011 - 11.2020
- Processed specimens for analysis adhering to established labeling and handling protocols.
- Assisted in maintaining laboratory equipment to ensure optimal functionality.
- Performed regular quality control assessments to maintain accuracy of results.
- Organized inventory of laboratory supplies and managed stock levels effectively.
- Documented laboratory procedures and results following standard operating protocols.
- Trained new staff on laboratory practices and safety procedures.
- Collaborated with healthcare professionals to facilitate sample collection processes.
- Facilitated sample preparation and data analysis for laboratory experiments.
- Assisted in sample preparation and analysis of data for laboratory experiments.
- Followed standard operating procedures while conducting experiments.
- Operated various pieces of equipment such as microscopes, centrifuges, balances, spectrophotometers.
- Processed specimens from clinical samples for testing in the laboratory.
- Troubleshooted technical problems that arose during laboratory procedures.
- Prepared cultures using sterile techniques and monitored their growth over time.
- Disposed of hazardous waste following proper safety guidelines.
- Maintained an inventory of supplies and reordered as needed.
- Used time management and adaptability skills to prioritize and run multiple tests.
- Utilized Laboratory Information Management Systems (LIMS) for tracking, documenting, and reporting laboratory activities.
- Conducted literature and online research to stay informed about current trends and advancements in laboratory techniques.
- Utilized aseptic techniques to prevent contamination and ensure the integrity of samples and cultures.
- Participated in regular laboratory meetings to discuss test results, quality control issues, and process improvements.
- Developed exemplary rapport with personnel and stakeholders by demonstrating compassion and scientific expertise.
Education
Some College (No Degree) - Python Basics
University of Pennsylvania
Philadelphia, PA04-2023
Phlebotomy Technician - Phlebotomy
Johnson County Community College
Overland Park, KS11-2010
Bachelor of Arts - Education
University College of Teacher Education
Nedumkandam04-1997
Bachelor of Arts - Economics
Pt. Ravishankar Shukla University
Raipur10-1993
Bachelor of Arts - Sociology
Pt. Ravishankar Shukla University
Raipur10-1993
Bachelor of Arts - English
Pt. Ravishankar Shukla University
Raipur10-1993
Some College (No Degree) - Software Testing
H2K Infosys
Alpharetta, GASkills
- Electronic health records
- Authorization processing
- HIPAA compliance
- Communication skills
- Adaptability
- Problem solving
- Training facilitation
- Accuracy and precision
- Documentation auditing
- Customer service
- Healthcare collaboration
- Conflict resolution
- Quality control
- Attention to detail
- Decision-making skills
- Confidentiality maintenance
- Multitasking capacity
Certification
- phlebotomy Technician
Languages
English
Professional
Malayalam
Professional
Hindi
Professional
Accomplishments
- Top Productive Member at current department
References
References available upon request.
Timeline
Authorization Representative II
Centene Corporation
11.2020 - Current
Lab Tech Assistant
Menorah Medical Center
06.2011 - 11.2020
Some College (No Degree) - Python Basics
University of Pennsylvania
Phlebotomy Technician - Phlebotomy
Johnson County Community College
Bachelor of Arts - Education
University College of Teacher Education
Bachelor of Arts - Economics
Pt. Ravishankar Shukla University
Bachelor of Arts - Sociology
Pt. Ravishankar Shukla University
Bachelor of Arts - English
Pt. Ravishankar Shukla University
Some College (No Degree) - Software Testing
H2K Infosys
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