Tristin Moore
Healthcare
Piedmont,MO
Summary
Dedicated Authorization Specialist with extensive experience in customer service and medical documentation. Proven ability to manage complex processes while ensuring compliance with regulatory standards, resulting in efficient claims processing and improved patient outcomes.
Overview
11
11
years of professional experience
Work History
Authorization Specialist
Centene Corporation
Remote, MO
08.2024 - Current
- Processed and reviewed authorization requests and other medical documents ensuring compliance with regulatory standards and company policies.
- Managed time effectively to meet daily expectations and ensure deadlines were met without compromising accuracy or attention to detail demonstrating a strong work ethic and commitment to meeting department goals.
- Documented necessary medical information such as history, diagnosis, and prognosis based on the authorization to the clinical reviewer for determination to expedite claims processing for faster resolution by efficiently inputting claim details into the system.
- Assists utilization management team with ongoing tracking and performs data entry to maintain and update authorization requests, referrals, claims and other medical documents in accordance with policies and guidelines.
- Remains up to date on healthcare, authorization processes and procedures to comply with all company and state policies and standards.
- Performs other duties as assigned.
Pharmacy Resolution Specialist
Centene Corporation
Remote, MO
04.2023 - 08.2024
- Utilized CRM software to track interactions and manage patient accounts effectively.
- Managed high call volumes while providing exceptional customer support and maintaining professional composure to resolve caller inquiries and issues efficiently ensuring high levels of satisfaction
- Mastered multiple software systems for seamless navigation during calls, improving efficiency and reducing hold times for customers.
- Reduced average call handling time, ensuring prompt service to caller while maintaining quality interactions to enhance patient satisfaction by efficiently addressing and resolving inquiries in a timely manner.
Customer Service Representative
AT&T Wireless
Remote, MO
05.2021 - 09.2022
- Assisted customers with inquiries, providing prompt and accurate information to enhance satisfaction.
- Resolved customer complaints efficiently, ensuring timely follow-up and issue resolution.
- Maintained thorough knowledge of products and services to offer tailored recommendations.
- Processed orders accurately, managing transactions through company systems effectively.
- Developed rapport with customers to understand needs and recommend suitable products.
Unit Secretary
Poplar Bluff Regional Medical Center
Piedmont, MO
06.2018 - 04.2020
- Managed patient admissions and discharges, ensuring accurate documentation and timely processing.
- Coordinated communication between medical staff and patients to facilitate effective care delivery.
- Scheduled appointments and maintained calendars for multiple healthcare providers efficiently.
- Processed medical records and patient information using electronic health record (EHR) systems.
- Oversaw daily office operations, ensuring compliance with healthcare regulations and policies.
- Supported hospital compliance efforts by adhering to privacy policies and HIPAA regulations when handling sensitive patient information.
- Assisted with the training and onboarding of new unit secretaries and administrative staff by sharing expertise on hospital protocols and operational procedures.
- Coordinated communication between medical staff and patients'' families, keeping everyone informed on treatment plans and progress updates.
- Managed inventory levels of office supplies, ensuring adequate stock was available at all times for efficient unit operations.
- Demonstrated flexibility in adjusting work hours to meet fluctuating demands of the unit, ensuring coverage during both peak times and staff shortages.
Head Hostess
143 Country Kitchen
Patterson, MO
06.2015 - 01.2018
- Managed guest seating arrangements to optimize flow and minimize wait times.
- Trained new staff on menu items, service protocols, and best practices and supervised front-of-house staff to ensure exceptional customer service standards.
- Coordinated with kitchen staff to communicate special requests and dietary restrictions, served food and beverages to ensure timely delivery and guest satisfaction.
- Developed strategies for enhancing guest experiences through personalized service and attention to detail in high-volume dining environment.
Education
High School Diploma -
Clearwater High School
Piedmont, MO04.2018
Skills
- Insurance verification
- Policy interpretation
- Confidentiality
- Active listening
- Task prioritization
- Professionalism
- Claim research
- Customer service
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Timeline
Authorization Specialist
Centene Corporation
08.2024 - Current
Pharmacy Resolution Specialist
Centene Corporation
04.2023 - 08.2024
Customer Service Representative
AT&T Wireless
05.2021 - 09.2022
Unit Secretary
Poplar Bluff Regional Medical Center
06.2018 - 04.2020
Head Hostess
143 Country Kitchen
06.2015 - 01.2018
High School Diploma -
Clearwater High School