Tricia Hinson
Burlington,NC
Summary
Patient-oriented Nurse with 26 years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with Dermatology specialty.
Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows. Organized professional knowledgeable in regulatory standards and compliance requirements.
Overview
28
28
years of professional experience
Work History
Nurse Manager
Alamance Dermatology
09.1996 - Current
- Led staff meetings to keep team informed of departmental changes and provide opportunities for medical assistants to share ideas and concerns.
- Trained new clinical staff in proper techniques, care standards, operational procedures, and safety protocols.
- Managed staff scheduling and time off to adequately staff clinics and allow earned time off.
- Served as a key point of contact between nursing staff, physicians, administration, and other healthcare professionals.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated family members and caregivers on patient care instructions.
Prior Authorization Specialist
Alamance Dermatology
09.2018 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
- Continually updated knowledge on industry developments, ensuring adherence to best practices and relevant regulatory changes impacting the prior authorization process.
Education
Associate of Applied Science - Nursing
Alamance Community College
Graham, NC05.2002
Skills
- Prior Authorization Process
- ICD-10 Coding Familiarity
- Medical Appeals Handling
- Medicare and Medicaid knowledge
- Electronic Health Records Proficiency
- Clinical Documentation Improvement
- Knowledgeable in Word, Excel and PowerPoint
- Hiring and Terminations
Affiliations
- Member of BCOD
Timeline
Prior Authorization Specialist
Alamance Dermatology
09.2018 - Current
Nurse Manager
Alamance Dermatology
09.1996 - Current
Associate of Applied Science - Nursing
Alamance Community College
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