Toi Barron
Medical Insurance Verifier / Prior Authorization Specialist
Fort Pierce,FL
Summary
Self-motivated insurance verification specialist proudly offering several years' experience building an understanding of medical terminology while tracking patient coverage. A poised professional with benefits explanation and administration expertise. Offering time management and interpersonal skills.
Overview
12
12
years of professional experience
Work History
Front Desk Medical Receptionist / Referral / Insurance Verifier / Prior Authorization Specialist
Dr. Pramod Joseph
02.2018 - Current
- Company Overview: Gastroenterologist Specialist
- Called referrals and schedule patients for office visits, EGD's and Colonoscopy procedures
- Contacted insurance companies to verify insurance information for office visits and procedures
- If auth was required it would be submitted for approval / denial before the office visit or procedure is scheduled
- Called each patient 2 days prior to their appointment as a reminder for the upcoming appointment
- Welcomed and Greeted patients, visitors, and Drug Representatives and directed them accordingly
- Kept patients appointments on schedule by notifying the provider in a timely manner
- Answered phone to assisted patients, doctors, pharmacies and insurance companies with any problems or concerns
- Gastroenterologist Specialist
Customer Service Representative
Convey Health Solutions / CVS Caremark / SilverScript
12.2012 - 02.2018
- Enrolled patients into a Health Plan of their choice from October 15 through December 7
- Educated beneficiaries on how the Part D prescription drug plan works, including benefits, cost share and level coverage
- Looked up medications on the formulary to verify if they are covered, the tier and co-pay level of coverage
- Assisted pharmacist with prescription denials, errors and verified benefits
- Advised providers on how to start PA's on medications that had restrictions such as step therapy and quantity limits
- Submitted 30 - 90 day mail orders for patients in all 50 states
Education
Diploma -
St. James Academy
01.2004
Skills
- Insurance Verification
- Understanding of medical terms
- Precertification requirements
- Medical Terminology
- Patient Scheduling
- Medicare and Medicaid knowledge
- Communication and Interpersonal Skills
- Coordination and Scheduling
- Eligibility Determination
- HIPAA Compliance Knowledge
- Electronic Medical Records
- Attention to Detail
- HIPAA Compliance
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridImportant To Me
Paid time off401k matchPaid sick leave4-day work weekWork from home optionCareer advancementTimeline
Front Desk Medical Receptionist / Referral / Insurance Verifier / Prior Authorization Specialist
Dr. Pramod Joseph
02.2018 - Current
Customer Service Representative
Convey Health Solutions / CVS Caremark / SilverScript
12.2012 - 02.2018
Diploma -
St. James Academy
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