Terrence Saunders
Round Rock,TX
Summary
Brings a proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs. Proficient in training and developing work process efficiency. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
9
9
years of professional experience
Work History
Authorization Specialist II
Superior HealthPlan
03.2020 - Current
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Led Interdepartmental Collaboration: Spearheaded collaborative projects with the claims department, demonstrating strong autonomy and leadership. Optimized authorization processes that improved operational efficiency and reduced time-to-resolution for complex cases.
- Established Trust and Reliability: Cultivated lasting relationships with healthcare providers, recognized for dependability and the ability to resolve most provider-born issues either through departmental insight or cross-department outreach.
- Subject Matter Expert: Acted as a key resource and impromptu trainer for the overall authorization process, educating new and existing staff on multiple service types and ensuring uniform understanding across the team.
- Pioneered Departmental Expansion: Selected for a lateral transfer to a newly established department (inpatient team to PA team), helping build operational structures from the ground up.
Referral Specialist
Dean's Professional Services
10.2019 - 03.2020
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Verified insurance benefits and eligibility for Behavioral procedures.
- Advocated for, then helped revise work process guidelines and training methodology within a month of being hired as a temp.
- Met and exceeded FTE processing and quality standards within 2 weeks
Medical Document Representative
Health Net, Centene
08.2015 - 01.2019
- Reviewed medical documentation with a comprehensive understanding of medical terminology, ensuring adherence to HIPAA compliance.
- Trained new associates and senior management on processing specialty document queues and resolved escalated authorization requests from the VA.
- Played a key role in developing tracking systems for authorizations, significantly improving the timeliness and accuracy of service provision.
- Redesigned the Work process guidelines which were officially implemented by senior management.
Customer Service Representative
Able Force Staffing Agency
06.2015 - 08.2015
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Provided expert customer service as part of a temporary role, quickly resolving inquiries
- Demonstrated strong capability in managing multiple tasks, enhancing customer satisfaction and operational efficiency.
- Due to exemplary processing and quality standards a contract buyout was offered after 2 weeks for FTE.
Education
High School Diploma -
Del Campo High School
Fair Oaks, CANo Degree - Computer Engineering
American River College
Sacramento, CASkills
- Medical terminology expertise
- Claims Management
- Medical coding knowledge
- Insurance Verification
- Prior authorization processing
- Data entry proficiency
- Staff Training
- Goal-oriented mindset
- Performance Improvement
- Performance Tracking
Timeline
Authorization Specialist II
Superior HealthPlan
03.2020 - Current
Referral Specialist
Dean's Professional Services
10.2019 - 03.2020
Medical Document Representative
Health Net, Centene
08.2015 - 01.2019
Customer Service Representative
Able Force Staffing Agency
06.2015 - 08.2015
High School Diploma -
Del Campo High School
No Degree - Computer Engineering
American River College
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