Tramoria Young

• Streamlined prior authorization processes, ensuring timely approvals for patient services.
• Collaborated with healthcare providers to gather necessary documentation for authorization requests.
• Utilized electronic health record systems to track and manage prior authorization workflows.
• HIPAA compliant.
• Implemented quality control measures to enhance accuracy in authorization submissions.
• Verified eligibility and compliance with authorization requirements for service providers.

• Coached and reviewed associates on job performance to help maximize customer satisfaction for 15 – 20 employees.

• Developed over 10 members for management/leadership roles.

• Managed inventory control, and store opening and closing procedures.

• Set effective store schedules based on forecasted customer levels, individual employee knowledge and service requirements.

• Reviewed and monitored scheduling, purchases and other expenses to maintain monthly budget.

• Created routes for drivers to make deliveries in a timely and efficient manner.

• Increased store profitability by implementing cost-saving measures and efficient inventory management strategies.

• Receive emergency calls from residents and staff and dispatch appropriate personnel; page on-call physicians as needed in an accurate and calm manner
• Track status of resident involved in a situation, i.e. transported to a hospital, etc.
• Collaborated with healthcare staff to verify alignment of appointment scheduling with clinic protocols.
• Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy.

• Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
• Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
• Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
• Educated clients about health insurance coverage options, benefits and costs.
• Assisted clients with filing and tracking health insurance claims to facilitate swift settlements.
• Verified eligibility and compliance with authorization requirements for service providers.
• Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
• Managed approximately 40-50 incoming calls