Part B Authorization Specialist - Team Manager
Tara Schave
Communicare
Woodville,Ohio
13
Years of experience
Results-driven Prior Authorization Supervisor with over 8 years of experience in healthcare authorization and accounts receivable. Leads teams to enhance submission accuracy, enforce Medicare Part B standards, and reduce claim rejections through automated reminders. Focused on optimizing workflows and decreasing verification cycles to safeguard revenue and enhance patient care.
Work History
Part B Authorization Specialist - Team Manager
3 Years 6 Months- Led team of authorization specialists, assigning daily workloads and tracking completion metrics to ensure timely claim processing.
- Reduced claim denial cycle by redesigning submission checklist for Medicare Part B documentation compliance.
- Processed prior authorization requests via healthcare portal and secured approvals before procedure dates.
- Coordinated with billing to reconcile authorization numbers before claim submission, minimizing claim rejections.
- Piloted automated reminder messages for missing attachments, increasing complete submissions from staff.
- Facilitated weekly training sessions for authorization specialists on policy updates and appeal workflows, enhancing team knowledge and compliance.
- Negotiated direct contact points with top payers to shorten verification cycles and clarify criteria.
- Built weekly operational dashboards showing authorization volume, denial reasons, and team performance trends.
Accounts Receivable Specialist
2 Years 9 Months- Resolved insurance denials by researching claim codes and resubmitting corrected claims to payers.
- Investigated aged receivables over 90 days, generating payer-specific action lists to enhance collection call effectiveness.
- Prepared and submitted corrected electronic claims via Availity after coding audits to recover denied payments.
- Processed daily patient account transactions in the billing system, posting insurance adjustments accurately.
- Reconciled patient ledgers against EOBs to identify underpayments and initiate supplemental claims.
- Prepared monthly aging analyses by payer type, enabling targeted collection strategies for finance leads.
- Compiled weekly AR performance reports for finance leaders, detailing top denial reasons and outlining recovery action items.
- Maintained HIPAA-compliant records for billing correspondence and claim files during audits.
Verifications Coordinator
1 Year 11 Months- Verified insurance coverage for services provided and submitted claims to ensure timely service delivery.
- Scheduled re-verifications for recurring patients, avoiding service interruptions for established clients.
- Trained new hires on verification workflows and healthcare software, enhancing team accuracy and throughput.
- Communicated complex benefit limitations to clinicians, enabling accurate care planning and referrals.
Dispatcher Coordinator
2 Years 5 Months- Coordinated daily dispatch for home service technicians across incoming customer requests.
- Monitored service board changes and adjusted routes for urgent home repair calls.
- Verified work orders, service details, and technician assignments before dispatching.
- Resolved scheduling conflicts with customers and field staff in Home Service Corporation operations.
- Communicated job updates between dispatch teams, technicians, and customer service staff.
- Supported customer calls with clear directions, timing updates, and appointment confirmations.
- Scheduled service appointments using home service operations systems and call logs.
- Trained new staff on the use of dispatching software and systems.
Education
Associate of Applied Sciences
- Dean's list recipient
- GPA: 3.95
Skills
Automation workflows
Healthcare systems
HIPAA regulations
Process efficiency
Team Leadership
Adaptability
Time Management
Process efficiency
Problem solving
Dispatch coordination
Route scheduling
Order tracking
Team Leadership
Time Management
Adaptability
Personal Information
Title: Prior Authorization Supervisor
Timeline
Part B Authorization Specialist - Team Manager
Communicare
05.2023 - CurrentRead More
Accounts Receivable Specialist
ProMedica Senior Care
08.2020 - 05.2023Read More
Verifications Coordinator
Ohioans Home Healthcare
04.2018 - 03.2020Read More
Dispatcher Coordinator
Home Service Corportation
07.2013 - 12.2015Read More
Baker College
Associate of Applied Sciences
Read More