Stephanie Wilson
Travelers Rest,SC
Summary
Experienced healthcare administrative professional with 12+ years in referral management, insurance authorization, and care coordination. Skilled in managing high-volume workflows, improving processes, and supporting multidisciplinary teams. Advanced knowledge of Epic, payer guidelines, and patient access operations. Recognized for problem-solving, staff training, and maintaining efficient, compliant workflows, with prior experience in hospital care management, discharge planning, and post-acute coordination.
Overview
10
10
years of professional experience
Work History
Referral & Insurance Specialist
Bon Secours Mercy Health
Greenville, SC
01.2022 - Current
- Lead referral and authorization workflows to ensure timely patient access across multiple service lines
- Obtain and manage prior authorizations for procedures, therapy, and imaging via Epic, payer portals, and direct communication
- Perform insurance verification (eligibility, benefits, limitations) to prevent denials and delays
- Coordinate scheduling with internal teams and external facilities to reduce gaps in care
- Resolve authorization discrepancies, denials, and payer issues through proactive follow-up
- Maintain accurate, compliant documentation in Epic, including payer communications and authorization details
- Manage high-volume work queues, prioritizing urgent and time-sensitive cases
- Serve as a subject matter expert; train new staff and support workflow improvements across teams
Representative I
CVS Caremark
Greenville, SC
01.2020 - 01.2022
- Processed pharmacy prior authorizations in compliance with clinical guidelines and payer policies
- Evaluated medication requests for medical necessity and formulary compliance
- Managed high-volume calls from providers and healthcare teams with accuracy and efficiency
- Communicated authorization decisions clearly to providers and care teams
- Conducted research to support clinical determinations and appropriate medication use
- Maintained accurate, compliant documentation meeting regulatory standards
- Collaborated with teams to resolve escalations and improve turnaround times
Support Specialist – Care Management
Prisma Health
Greenville, SC
01.2019 - 01.2020
- Coordinated discharge planning and facilitated referrals to post-acute care facilities including SNF, rehab, and home health services
- Served as a liaison between patients, families, providers, and external facilities to ensure smooth transitions of care
- Managed payer communication for authorizations, coverage verification, and discharge-related services
- Prepared and delivered regulatory notification letters to patients and families in compliance with hospital policies
- Maintained ongoing communication with case management teams and post-acute providers to track patient placement and status
- Managed work queues to ensure timely processing of referrals, authorizations, and billing-related tasks
- Documented all patient interactions and care coordination activities within the electronic medical record
- Performed follow-up on patient transitions to confirm continuity of care and prevent delays
- Identified workflow gaps and reported trends to leadership, contributing to process improvements
Admissions Counselor
Prisma Health
Greenville, SC
01.2017 - 01.2019
- Verified patient demographics, insurance eligibility, and benefits to ensure accurate registration and billing
- Initiated and tracked prior authorizations for procedures and services to prevent delays in care
- Provided cost estimates and educated patients on financial responsibility, improving transparency and patient satisfaction
- Maintained working knowledge of CPT and ICD-10 codes to support accurate documentation and authorization requests
- Managed work queues to ensure timely claim processing and minimize billing errors
- Communicated effectively with providers, insurance companies, and patients to resolve issues and ensure accurate information
Intake Specialist
New Horizon
Greenville, SC
01.2016 - 01.2017
- Conducted comprehensive patient intake assessments and verified eligibility for services, including grant-funded programs
- Ensured compliance with Ryan White and other program requirements through accurate documentation and verification
- Managed patient scheduling, reminder calls, and follow-up for incomplete documentation
- Maintained and updated patient records in EHR systems (AthenaNet, Provide Enterprise)
- Communicated patient financial responsibilities and assisted with resolving concerns
- Coordinated with clinical and administrative teams to support efficient patient flow and service delivery
- Maintained accurate databases and generated reports as requested by leadership
Education
Associate of Science - Management
Greenville Technical College
Greenville, SC2020
Skills
- Payer Communication & Insurance Coordination
- Prior Authorization & Denial Management
- Transition of Care & Discharge Coordination
- EMR Documentation & Workflow Management (Epic)
- Patient & Care Team Communication
- Referral Management & Post-Acute Coordination
- Regulatory Compliance & Patient Rights Communication
- Time Management & High-Volume Task Prioritization
Timeline
Referral & Insurance Specialist
Bon Secours Mercy Health
01.2022 - Current
Representative I
CVS Caremark
01.2020 - 01.2022
Support Specialist – Care Management
Prisma Health
01.2019 - 01.2020
Admissions Counselor
Prisma Health
01.2017 - 01.2019
Intake Specialist
New Horizon
01.2016 - 01.2017
Associate of Science - Management
Greenville Technical College