Summary
Overview
Work History
Education
Skills
Timeline
Generic

Wendy Fowler

Brighton,TN

Summary

Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.

Overview

34
34
years of professional experience

Work History

Authorization Specialist

Panorama Summit Orthopedics
01.2023 - Current
  • Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
  • Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
  • Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
  • 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.
  • Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
  • Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
  • Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
  • Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Analyzed medical records and other documents to determine approval of requests for authorization.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
  • Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
  • Tracked referral submission during facilitation of prior authorization issuance.
  • Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
  • Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
  • Collect on self-pay patients on behalf of the physicians.
  • Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.

Lead Scan Coordinator

Kroger Co.
10.2000 - 02.2023
  • Complete price changes and maintain proper signage for products
  • Greet customers and deliver excellent customer service to promote sales and repeat business
  • Plan workflow, employee scheduling and assigned duties to maintain performance and accommodate fluctuating workloads
  • Inform upper management or department heads of items loaded or problem encountered
  • Work successfully with diverse groups of coworkers to accomplish goals and address issues related to our products and services
  • Address pricing discrepancies by researching original price and fixing inaccurate information
  • Work closely with team members to deliver project requirements, develop solutions and meet deadlines
  • Prioritize and organize tasks to efficiently accomplish service goals
  • Juggle multiple projects and tasks to ensure high quality and timely delivery
  • Travel to different locations helping with vacation relief and supporting their store staff.
  • Maintained up-to-date knowledge on company policies, state regulations, and industry best practices related to pricing compliance.
  • Developed effective communication channels between departments, fostering collaboration on planogram changes and pricing initiatives.
  • Enhanced team productivity by implementing efficient scanning processes and strategies.
  • Implemented quality control measures for accurate tagging and labeling of products throughout the store.
  • Streamlined inventory management tasks for improved accuracy and reduced discrepancies.
  • Identified areas of improvement within the scanning process, implementing innovative solutions to enhance efficiency and reduce costs.
  • Resolved scanning issues promptly, maintaining a smooth workflow in the front-end operations.
  • Coordinated with department managers to ensure proper execution of pricing updates and sales promotions.
  • Organized efficient work schedules for scan coordinators to optimize coverage during peak business hours and minimize overtime costs.
  • Managed price change workload effectively, ensuring timely completion of all tasks within deadlines.
  • Oversaw the maintenance of scanning equipment, ensuring optimal performance while reducing downtime due to malfunctions or repairs.
  • Conducted regular audits to maintain accurate pricing information, minimizing errors and customer complaints.
  • Trained and mentored new scan coordinators, promoting teamwork and boosting overall efficiency.
  • Monitored sales events for accuracy in scanning and signage, maintained current knowledge of weekly ad items and verified pricing integrity.
  • Researched scan error sheets and not-on-file sheets promptly, corrected errors found and kept log of manual retail price changes.
  • Verified accuracy of prices charged to customers and confirmed attachment of correct attribute information.
  • Executed correct signage placement in each aisle and department and replaced missing signs before store opening.
  • Supervised team of helpers, laborers and material movers to efficiently complete tasks.
  • Trained new staff on job duties, company policies, and safety procedures for rapid onboarding.
  • Participated in regular team meetings to stay informed about company policies, procedures, and best practices relevant to the Scan Coordinator role.

Bagger, Cashier, Front-end Supervisor, Guest Care Associate

Kroger Co.
04.1990 - 10.2000
  • Worked together with cashiers to guarantee customer satisfaction.
  • Took on extra hours and shifts during busy periods to meet tight shipping deadlines.
  • Served as point of contact between customers and store associates or management.
  • Worked flexible schedule and extra shifts to meet business needs.
  • Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
  • Maintained a balanced cash drawer, ensuring accurate accounting at the end of each shift.
  • Counted money in cash drawers at beginning and end of shifts to maintain accuracy.
  • Assisted customers with returns, refunds and resolving transaction issues.
  • Mentored new employees on cashier duties and best practices, improving overall staff performance.
  • Maintained a clean and organized front-end area to ensure a pleasant shopping experience for customers.
  • Handled customer inquiries and suggestions courteously and professionally.
  • Answered customer telephone calls promptly to avoid on-hold wait times.

Education

Associates Degree - Business Communications

State Tech Institute of Memphis
Memphis

High School Diploma -

White Station High School
Memphis

Skills

  • Excellent multitasker

  • Strong communication skills

  • Exceptional leader

  • Friendly and outgoing

  • Team-oriented

  • Quick learner

  • Problem resolution

  • Medical terminology expertise

  • Insurance Verification

  • Prior authorization processing

  • Knowledgeable in EPIC

  • Authorizations understanding

Timeline

Authorization Specialist

Panorama Summit Orthopedics
01.2023 - Current

Lead Scan Coordinator

Kroger Co.
10.2000 - 02.2023

Bagger, Cashier, Front-end Supervisor, Guest Care Associate

Kroger Co.
04.1990 - 10.2000

Associates Degree - Business Communications

State Tech Institute of Memphis

High School Diploma -

White Station High School

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Wendy Fowler