Walyah Diggs
Sumter,SC
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Focused team player familiar with helping patients develop skills such as feeding, grooming and dressing, as well as providing educational support and managing sensory processing issues. Hardworking, disciplined multitasker with analytical problem-solving and conflict management abilities.
Overview
6
6
years of professional experience
Work History
Prior Authorization Specialist
Colonial Family Practice
01.2020 - Current
- Input all patient data regarding claims and prior authorizations into system accurately.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Developed and maintained productive working relationships with healthcare providers.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
92G Culinary Specialist
South Carolina National Guard
07.2017 - Current
- Verified that daily nutritional and special culinary servings complied with laws, company regulations and accepted nutritional standards.
- Prepared nourishing, palatable and well-balanced meals to enhance formal, informal and offsite dining experiences.
- Partnered with sustainability team to minimize waste and creatively minimized global footprint in culinary operations.
- Conducted inspections of food preparation and dining facilities to verify compliance with health and safety regulations.
- Took inventory of supplies and maintained accurate stock records to minimize losses and support supply ordering.
- Developed menus and meal plans which met personnel needs, utilizing available supplies and within budget restrictions.
- Inspected deliveries for accuracy and safety.
- Maintained composure and work quality while under stress.
- Cleaned and maintained work areas, equipment and utensils.
- Maintained high personal grooming standards and uniform presentation.
- Seasoned and cooked food according to recipes or personal judgment and experience.
- Followed food safety practices and sanitation guidelines.
- Trained new staff on food preparation and safety procedures.
- Monitored food temperature, discarding items not stored correctly.
- Reduced kitchen accidents by maintaining high standards of cleanliness and organization.
- Maintained effective supply levels by monitoring and reordering food stock and dry goods.
Education
Associate of Science - Occupational Therapy Assistance
South University, Columbia, SC
Columbia, SC03.2024
Certificate - Professional Clinical Massage Therapy
SouthEastern College, Columbia, SC
Columbia, SC03.2019
Skills
- Patient Scheduling
- Medical Terminology
- Effective Communication Skills
- Patient Confidentiality Compliance
- Attention to Detail
- Multitasking Capabilities
- Critical Thinking Abilities
- Adaptability and Flexibility
- Organizational Skills
- Professionalism and Ethics
Timeline
Prior Authorization Specialist
Colonial Family Practice
01.2020 - Current
92G Culinary Specialist
South Carolina National Guard
07.2017 - Current
Associate of Science - Occupational Therapy Assistance
South University, Columbia, SC
Certificate - Professional Clinical Massage Therapy
SouthEastern College, Columbia, SC
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