Tracy Renstrom

Prior Authorization Specialist

Coram CVS Specialty Infusion Services

Eden Prairie, MN

03.2010 - 11.2022

Coordinated with other departments to obtain additional information needed for prior authorization.
Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation.
Facilitated communication between providers, payers and health plans regarding prior authorization processes.
Negotiated with drug manufacturers and insurance providers to obtain coverage for off-label or non-formulary medications.
Input claim, prior authorization, and other important medical data into system.
Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
Followed up on pending prior authorization requests to ensure timely processing.
Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
Maintained accurate records of all authorization activities in the database system.
Notified ordering providers of denied authorizations.
Educated healthcare providers on prior authorization requirements and insurance formulary changes.
Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
Communicated authorization decisions, including approvals and denials, to healthcare providers and patients.
Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
Reviewed prior authorization requests to ensure accuracy and completeness of required information.
Maintained positive working relationship with fellow staff and management.
Provided customer service to patients and healthcare providers, answering questions related to prior authorization and insurance coverage.