Tina Taylor
Columbus,OH
Summary
Prior Authorization Representative with over 18 years of experience, notably with Express Scripts. Expert in navigating insurance requirements and enhancing process efficiency.
Overview
19
19
years of professional experience
Work History
Medicare Part D. Representative
Temporary Employee - CVS Health
09.2023 - 09.2024
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Knowledge of insurance plan requirements, facilitating accurate and timely completion of Prior authorization forms.
- Viewed medical records/chart notes and other documents to determine approval of requests for Prior authorization.
- Verified eligibility with authorization requirements for service providers.
- Resolution Management task duties.
Coverage Representative Determination
Express Scripts
11.2005 - 04.2022
- Maintained knowledge of insurance plan requirements, and timely completion of Prior authorization forms.
- Collections Billing, Trainer, Prior Authorization Representative for Anthem, Medicaid, Medicare, Department of Defense & Commercial plans.
- Speak with Physicians, Pharmacists, Nurses and other agents about various aspects of the programs.
- Handled inbound, outbound & escalated calls in the most courteous and professional manner.
- Follow protocol in referring calls of professional or clinical nature to a pharmacist and ensure all protocols including scripting are followed to resolve call issues.
Education
Paralegal Associates Degree - Paralegal
Academy of Court Reporting
Columbus, Ohio04.1998
Certificate of Completion - Diploma
Northeast Career Center
Columbus, Ohio06.1993
High School Diploma -
Marion Franklin High School
1265 Koebel Rd. Columbus, Ohio 4320706.1993
Skills
- Prior Authorization Representative
- Typing speed 50-70 wpm
- Data entry proficiency
- Banking, Collections & Billing
- Word Perfect, Microsoft word
- Insurance CPT, ICD9, ICD10 & NDC coding for billing
- Staff Training
- Accounting and Auditing Services
- Call Center / Remotely
- Insurance
- Problem-solving abilities
Timeline
Medicare Part D. Representative
Temporary Employee - CVS Health
09.2023 - 09.2024
Coverage Representative Determination
Express Scripts
11.2005 - 04.2022
Paralegal Associates Degree - Paralegal
Academy of Court Reporting
Certificate of Completion - Diploma
Northeast Career Center
High School Diploma -
Marion Franklin High School
Similar Profiles
Rachel HesterRachel Hester
Family Nurse Practitioner at Novant Health-Employee Occupational Health and Corporate Health SolutionsFamily Nurse Practitioner at Novant Health-Employee Occupational Health and Corporate Health Solutions
Avery Gladue-AugerAvery Gladue-Auger
Babysitting at -Babysitting at -
Maria CapuanoMaria Capuano
International Make-Up Artist at -International Make-Up Artist at -
CRYSTAL WRIGHTCRYSTAL WRIGHT
Staff RN - Per Diem at Mount Carmel FirstChoiceStaff RN - Per Diem at Mount Carmel FirstChoice
Betzi RamirezBetzi Ramirez
Cashier at Toro Meat MarketCashier at Toro Meat Market