Yvette Thomas
Dallas,GA
Summary
Healthcare professional with 10+ years of experience in outpatient, behavioral health, and specialty care. Skilled in reviewing and evaluating prior authorization requests, applying clinical guidelines, and ensuring compliance with payer policies. Adept at collaborating with providers, insurers, and patients to expedite care approvals, reduce denials, and promote cost-effective, patient-centered services. Proficient in Epic EMR, payer portals, CPT/ICD/HCPCS coding, and regulatory guidelines including CMS and NCQA. Recognized for accuracy, timeliness, and strong clinical judgment in high-volume, deadline-driven environments.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Registered Medical Assistant
Willowbrooke Psychiatric Center
02.2023 - Current
- Review and process prior authorization requests for psychiatric services, ensuring compliance with payer-specific requirements.
- Collaborate with psychiatrists, therapists, and insurance representatives to facilitate timely approvals and minimize care delays.
- Document all authorization activities in Epic EMR and maintain accurate patient records in accordance with HIPAA.
- Educate providers and patients on authorization procedures, timelines, and alternative covered services.
- Escalate urgent or complex cases to supervising clinicians for expedited resolution.
- Collected and documented patient medical information such as blood pressure and weight.
- Performed medical records management, including filing, organizing and scanning documents.
- Called and faxed pharmacies to submit prescriptions and refills.
Registered Medical Assistant
WellStar Health System
06.2019 - 12.2022
- Verified medical necessity and obtained prior authorizations for specialty referrals, medications, and diagnostic procedures.
- Applied CPT, ICD-10, and HCPCS coding knowledge to ensure complete and accurate submissions.
- Maintained current knowledge of payer authorization requirements and clinical criteria.
- Resolved no-authorization denials by submitting retro authorization requests and providing supporting clinical documentation.
- Served as a liaison between providers, patients, and payers to ensure continuity of care.
Lead Medical Assistant/Senior MA
Emory Healthcare
12.2010 - 06.2019
- Oversaw prior authorization workflows for multiple specialty providers, ensuring timely and compliant processing.
- Collaborated with physicians and insurers to resolve complex authorization and coverage issues.
- Trained and mentored staff on authorization procedures, EMR documentation, and payer-specific guidelines.
- Assisted with quality improvement efforts to reduce delays and prevent unnecessary denials.
- Precepted newly hired medical assistants to train each on office procedures and important tasks.
- Met operational targets consistently by guiding and motivating medical assistant team to effectively handling administrative and clinical needs.
- Documented patient information in EMR and prepared paperwork for medical staff.
- Protected patients and staff from infection risks by routinely cleaning and disinfecting common areas and patient rooms.
- Triaged incoming calls for provider to determine callers' needs for immediate appointments or scheduled visits.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Monitored office procedures to correct problems and implement proactive improvements for better patient flow.
Education
Bachelor of Science - Psychology
Southern New Hampshire University
Manchester, NH10.2027
Certified Billing & Coding Specialist -
Penn Foster
2023
Certified Phlebotomy Technician -
Alford College
Decatur, GASkills
- Prior Authorization Review & Processing
- Clinical Guidelines Application (InterQual, MCG)
- CPT, ICD-10, HCPCS Code Verification
- Utilization Management & Case Review
- Payer Policies & Regulatory Compliance (CMS, NCQA)
- EMR Documentation & Authorization Portals
- Provider & Patient Education on Authorization Procedures
- Denial Prevention & Appeal Support
- HIPAA Compliance & Confidential Communication
Certification
- Registered Medical Assistant – American Medical Technologists
- Certified Billing & Coding Specialist – Penn Foster
- Phlebotomy Certification – Alford College
- BLS – American Heart Association
Languages
English
Native or Bilingual
Timeline
Registered Medical Assistant
Willowbrooke Psychiatric Center
02.2023 - Current
Registered Medical Assistant
WellStar Health System
06.2019 - 12.2022
Lead Medical Assistant/Senior MA
Emory Healthcare
12.2010 - 06.2019
Bachelor of Science - Psychology
Southern New Hampshire University
Certified Billing & Coding Specialist -
Penn Foster
Certified Phlebotomy Technician -
Alford College
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