Detail-oriented Prior Authorization Specialist with extensive experience in insurance verification, effective communication, and patient confidentiality compliance. Proven ability to manage complex medical documentation and expedite approvals.
Overview
21
21
years of professional experience
Work History
Prior Authorization Specialist
New Liberty Hospital Corporation
Liberty, MO
03.2005 - Current
Managed prior authorization requests, ensuring compliance with insurance protocols and regulations.
Analyzed complex medical documentation to determine eligibility for services and procedures.
Coordinated communication between healthcare providers and insurance representatives to expedite approvals.
Developed training materials for new staff on authorization processes and system navigation.
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.
Education
High School Diploma -
ANDERSON UNION HIGH SCHOOL
ANDERSON, CA
Skills
Prior authorization process
Medical appeals handling
Authorizations
Insurance verification
Effective communication skills
Patient referrals
Data entry
Electronic health records proficiency
Professionalism and ethics
Retro-authorizations
Patient confidentiality compliance
Patient scheduling
Interests
Swimming
Passionate about balancing physical health with mental and emotional wellness
Backpacking and Hiking
Gardening
Hiking
Community Cleanup
Youth Development Programs
Fundraising Events
Animal Welfare Advocacy
Participating in fundraising events to support local charities, schools, or community projects