Summary
Overview
Work History
Education
Skills
Computer Software
Timeline
Generic

Victoria Johnson

Hazlet,NJ

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.

Overview

11
11
years of professional experience

Work History

Prior Authorization Representative

Cigna-Evernorth Services Inc.
2022.06 - 2023.10
  • Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
  • Processed new medication and refill requests for authorization.
  • Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.
  • Fielded telephone inquiries on authorization details from plan members and medical staff.
  • Collaborated with healthcare providers to expedite the process of obtaining necessary medical documentation for medication prior authorization.
  • Contributed to departmental success by consistently meeting or exceeding performance metrics such as accuracy, productivity, and quality standards.
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Facilitated better communication between departments through proactive engagement with other teams involved in the prior authorization process.
  • Supported continuous improvement initiatives by actively participating in meetings, providing feedback, and suggesting areas for improvement.
  • Demonstrated adaptability by managing multiple priorities simultaneously, ensuring all tasks were completed accurately and on time.
  • Input all patient data regarding claims and prior authorizations into system accurately.
  • Responded to inquiries from healthcare providers regarding prior authorization requests.

Lead Medical Receptionist

Hackensack Meridian Health
2014.01 - 2022.06
  • Fielded concerns surrounding patients and care, liaising between physician, patient, and insurance company.
  • Verified and updated demographic and other personal information for clients with respect to personal boundaries when asking for important details.
  • Used computer programs and registration systems to schedule patients for routine and complex procedures.
  • Offered ample support to team members with creative solutions to complex challenges regarding scheduling, conflict resolution, and medical care.
  • Remained aware of provider schedules and scope of practice on evolving basis to organize and schedule appropriate care.
  • Referred and screened patients to make best use of resources, triage staff, and serve community members.
  • Increased patient satisfaction by promptly resolving any concerns or issues related to appointments or billing matters.
  • Coordinated referrals for specialist consultations, obtaining authorization from insurance carriers when necessary.
  • Participated in ongoing professional development opportunities relevant to the role of Lead Medical Receptionist.
  • Managed high call volume efficiently, directing callers to appropriate departments or personnel as needed.
  • Contributed to a positive work environment by fostering strong relationships with colleagues and displaying excellent teamwork skills.
  • Improved overall office organization by implementing a comprehensive filing system for patient records.
  • Prepared examination rooms for incoming patients, ensuring cleanliness and availability of necessary supplies.
  • Provided exceptional customer service to patients, addressing their needs promptly and professionally while demonstrating empathy and understanding.
  • Supported medical staff through diligent record-keeping of lab results, diagnostic reports, and other vital documentation.
  • Enhanced patient experience by streamlining check-in processes and maintaining accurate records.
  • Streamlined front desk operations by implementing an organized system for handling forms, mailings, and other administrative tasks.
  • Maintained clear communication lines between patients, providers, and insurance companies to address any billing discrepancies or concerns.
  • Displayed flexibility in accommodating last-minute schedule changes while maintaining orderliness within the practice.
  • Effectively communicated appointment reminders to patients through phone calls or email notifications, contributing to a decrease in noshows.
  • Ensured compliance with HIPAA regulations, safeguarding confidential patient information at all times.
  • Reduced wait times for appointments through efficient scheduling and coordination with medical staff.
  • Checked patient insurance, demographic, and health history to keep information current.
  • Coordinated patient scheduling, check-in, check-out and payments for billing.
  • Helped patients complete necessary medical forms and documentation.
  • Managed multi-line phone system and pleasantly greeted patients.
  • Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.

Cashier and Stock

Multiple Retail Jobs
2012.07 - 2014.01
  • Greeted customers entering store and responded promptly to customer needs.
  • Welcomed customers and helped determine their needs.
  • Worked flexible schedule and extra shifts to meet business needs.
  • Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
  • Restocked and organized merchandise in front lanes.
  • Stocked, tagged and displayed merchandise as required.
  • Unloaded, sorted and stocked merchandise according to store layout and product placement.
  • Placed products in correct storage locations to keep stock areas organized and inventory counts accurate.
  • Performed inventory control, such as counting, and stocking merchandise.
  • Rotated stock correctly to prevent out-of-date products and removed aging items from main shelving to build special promotional displays.

Education

High School Diploma -

Raritan High School
Hazlet, NJ

Skills

  • Basic medical terminology
  • Authorizations
  • Benefit Coverage
  • HIPAA Compliance
  • Insurance Verification
  • Data Entry
  • EMR / EHR
  • Adaptable and Flexible
  • Patient Referrals
  • Customer Service
  • Office Administration
  • Documentation and Recordkeeping

Computer Software

  • ESD
  • CSP
  • C360
  • OnePA
  • Citrix
  • Verint
  • WFO
  • KIM and KnowledgeXchange search engines
  • GE Centricity EMR
  • EPIC EMR
  • Microsoft Word and Outlook

Timeline

Prior Authorization Representative

Cigna-Evernorth Services Inc.
2022.06 - 2023.10

Lead Medical Receptionist

Hackensack Meridian Health
2014.01 - 2022.06

Cashier and Stock

Multiple Retail Jobs
2012.07 - 2014.01

High School Diploma -

Raritan High School
Victoria Johnson