Teresa Walker
Covington,GA
Summary
Customer Service and Healthcare Operations Specialist with 30+ years of experience delivering high-quality client support in telecommunications, healthcare utilization management, and account services. Skilled in case coordination, benefits eligibility, prior authorization, client relations, and project management. Adept at resolving complex customer inquiries, collaborating across departments, and ensuring compliance with organizational standards. Seeking to leverage expertise as a Customer Outreach Specialist to improve client engagement, satisfaction, and retention.
Overview
21
21
years of professional experience
Work History
Utilization Management Associate
Elevance Health
Atlanta, GA
09.2011 - 05.2025
- Coordinate pre certification and prior authorization requests, ensuring compliance with plan guidelines and clinical review requirements.
- Verify contract and benefit eligibility; issue authorizations for inpatient admissions, outpatient services, and post-service requests.
- Conduct clinical screening processes and assess benefits for facility-based treatments.
- Provide initial session authorizations to providers, supporting continuity of care.
- Manage high-volume incoming calls and post-service claims efficiently.
- Collaborate with nurses, providers, and internal departments to resolve escalated cases.
- Develop and maintain strong customer relationships, ensuring timely resolution of inquiries.
- Collaborated with healthcare providers to facilitate effective resource allocation and patient outcomes.
- Evaluated patient care plans to ensure compliance with utilization management protocols.
- Developed operational strategies to enhance efficiency and streamline processes across departments.
- Led cross-functional teams to implement project initiatives, ensuring alignment with organizational goals.
- Analyzed market trends to inform strategic planning and decision-making for product development.
- Mentored junior associates, fostering professional growth and enhancing team performance.
Accounts Manager
Bell South DSL Billing (AT&T)
Atlanta, GA
01.2004 - 09.2011
- Delivered world-class customer service for DSL clients, resolving complex billing and service issues.
- Led project management efforts: assigned resources, reviewed quality of work, and ensured risk management compliance.
- Oversaw quality control review of team submissions to ensure accuracy and adherence to corporate standards.
- Created and revised project work plans to align with changing requirements.
- Supported performance management by coaching peers and improving process efficiencies.
- Managed billing operations, ensuring accuracy and compliance with company policies.
- Developed strategies to enhance customer satisfaction and retention through effective account management.
Education
High School Diploma -
Greene County High
Greensboro, GA06.1982
Skills
- Client Relations
- Utilization Management
- Healthcare Case Coordination
- Eligibility Verification
- Project Management
- Problem Solving
- MS Office
- Facets
- SharePoint
- AUMI
- Professionalism and ethics
- NPPS
- ACUMI
- Pluto
- Critical thinking
- HIPAA compliance
Timeline
Utilization Management Associate
Elevance Health
09.2011 - 05.2025
Accounts Manager
Bell South DSL Billing (AT&T)
01.2004 - 09.2011
High School Diploma -
Greene County High
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