Tashonda Brown
Indianapolis,IN
Summary
Experienced and compassionate Prior Authorization Representative/ Patient Care Rep with over 10 years of dedicated service in patient services. Demonstrating a patient-oriented approach and a strong commitment to learning and growth, strives to provide exceptional care to every individual encountered. Expertise in delivering professional and compassionate patient care, consistently upholds a strong work ethic and prioritizes the well-being of those under care. Committed to maximizing efficiency and meeting the unique needs of each patient and medical staff member, dedicated to ensuring a positive and comfortable healthcare experience for all.
Overview
13
13
years of professional experience
Work History
Hospital Operator
Eskenazi Hospital
07.2022 - Current
- Supported management decision-making by compiling operational and production data into daily logs.
- Properly directed inbound calls in phone queues to improve call flow by 100%.
- Received incoming calls and paged individuals and departments over PA system.
- Directed incoming calls to internal personnel and departments, routing to best-qualified department.
- Handled emergency calls calmly and effectively, providing swift assistance during critical situations.
- Maintained confidentiality of sensitive patient information, adhering strictly to HIPAA guidelines while performing operator duties.
- Prioritized urgent requests appropriately while managing routine calls simultaneously, maintaining composure under pressure.
- Provided exceptional customer service to patients and visitors, fostering a welcoming atmosphere within the hospital setting.
Prior Authorization Representative/ Pt Care Rep
Express Scripts
12.2014 - Current
- Responded to customer requests via telephone (inbound/outbound) and email.
- Scheduling Medications to ship via mail
- Entered details such as payments, account information and call logs into the computer system.
- Accurately inputted all patient and insurance claims information
- Effective escalation handling and resolving patient needs
- Processed new medication and refill requests for authorization.
- Reviewed insurance coverage for patients to determine which party was liable for payment.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.
- Collaborated with healthcare providers to expedite the process of obtaining necessary medical documentation for approvals.
- Resolved patient billing inquiries and other issues efficiently.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
Personal Care Assistant
Help At Home
05.2012 - 09.2020
- Completed regular check-ins and progress report for each client.
- Maintained strong connections within the caregiver community to gain continuous knowledge.
- Provided compassionate and patient-focused care to cultivate well-being.
- Monitored clients’ overall health and well-being and noted any significant changes.
- Planned activities to encourage movement, when permitted.
- Transported clients to and from medical appointments with safety and efficiency.
- Built and maintained rapport with clients and family members to facilitate a trusting caregiver relationship.
- Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
Warehouse Associate
Amazon Warehouse
10.2011 - 05.2012
- Assembled and filled orders to be shipped to customers and prepared all shipping documentation.
- Verified the quantity and description of materials received by checking merchandise against the packing list.
- Inspected products for defects and damages and examined incoming and outgoing shipments.
- Kept warehouse clean and organized .
- Entered quantity received against the purchase order in the computer system.
Education
RN Program - Nursing
Fortis College - Indianapolis
Indianapolis, INDiploma - Medical Assisting
Kaplan College - Indianapolis
Indianapolis, INDiploma - General
Robbinsdale Cooper Senior High School
New Hope, MNSkills
- Strong communication skills
- Customer service-oriented
- Microsoft Office proficiency
- Medical terminology
- Insurance coverage verification
- Multitasking ability
- Benefit Coverage
- Medicare and Medicaid knowledge
- Authorizations
- HIPAA Compliance
- Excellent Phone Demeanor
- Switchboard Operation
Timeline
Hospital Operator
Eskenazi Hospital
07.2022 - Current
Prior Authorization Representative/ Pt Care Rep
Express Scripts
12.2014 - Current
Personal Care Assistant
Help At Home
05.2012 - 09.2020
Warehouse Associate
Amazon Warehouse
10.2011 - 05.2012
Diploma - Medical Assisting
Kaplan College - Indianapolis
Diploma - General
Robbinsdale Cooper Senior High School
RN Program - Nursing
Fortis College - Indianapolis
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