Riley Lovett
Alton,IL
Summary
Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist (Remote)
Evernow
San Francisco, CA
01.2024 - Current
- Recorded and documented authorization activities in the database system with accuracy.
- Researched clinical criteria and determined eligibility for requested services based on plan provisions.
- Demonstrated ability to work independently as well as collaboratively within a team environment.
Prior Authorization Coordinator (Remote)
Alpha Medical
Palo Alto, CA
05.2022 - 10.2023
- Coordinate effective communication to ensure a positive experience for patients, insurance providers, healthcare staff, and office personnel
- Respond to inquiries efficiently via the company's online chat feature
- Coordinate resolutions for issues and appealed denied authorizations.
- Communicates with providers when there are discrepancies between the code and the documentation
- Proper use of ICD10, CPT/CPT II and HCPCS codes
Prior Authorization Coordinator (Remote)
Insight Global
, GA
11.2021 - 05.2022
- Reviewed and processed prior authorization requests according to insurance guidelines.
- Processed high volume of requests within established turnaround times while maintaining quality standards.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
Pharmacy Technician
Walgreens
Collinsville, IL
11.2016 - 11.2019
- Collaborate with doctor's offices and insurance companies to ensure accurate prescription information and documentation
- Manage pharmacy operations related to label printing, medication distribution, and insurance billing, contributing improvement in patient satisfaction
Education
Bachelor of Science - Mass Communications
Southern Illinois University
Edwardsville, IL12.2020
Associate of Science -
Lewis and Clark Community College
Godfrey, IL05.2015
Skills
- Prior authorizations, Insurance billing, Insurance verification, Customer issue resolution, Data management
- Experience with Microsoft products such as Word, Excel, Outlook & Internet Explorer
- Zendesk
- Ability to write simple correspondence
- Athena
Certification
- Certified Pharmacy Technician (CPhT)
Timeline
Prior Authorization Specialist (Remote)
Evernow
01.2024 - Current
Prior Authorization Coordinator (Remote)
Alpha Medical
05.2022 - 10.2023
Prior Authorization Coordinator (Remote)
Insight Global
11.2021 - 05.2022
Pharmacy Technician
Walgreens
11.2016 - 11.2019
Bachelor of Science - Mass Communications
Southern Illinois University
Associate of Science -
Lewis and Clark Community College
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