Description
QUALIFICATIONS SUMMARY 3 years' experience as a Patient Access Coordinator and Prior Authorization Coordinator. Willing to learn and further my experience in the medical industry as a loyal, dependable candidate who is ready to learn and be taught what the company values. PROFESSIONAL EXPIERIENCE Premier Kids Care - AugustaMonroe, GA Prior Authorization Specialist May 2012 - 2016 * Ensuring all required demographic, insurance, referral/authorization, clinical data is collected * Conduct pre-authorization before patient's visit * Perform insurance verification tasks before patient's visit * Responsible for making sure patients were renewed for Insurance/Benefits before expiration date. * Kept track of patient records needed for refills on medication * Communicated on a daily basis with Doctors, hospitals, and Insurance companies including Medicaid patients from various states * Reached out to patients on daily basis * Reached out to patients collecting Payment * Submitted claims to insurance company * Responsible for escalated calls * Maintained Reports and logs per patient * Daily update on patient history * Worked with ICD9-ICD10 codes per each Medical disorder * Reading clinicals, labs, and Charts per patient * Converse with insurance companies on a day to day basis from all over the states. Familiar with policies and requirements for each insurance companies and * Filed for appeals when Authorizations were denied Premier Kids Care Pharmacy-Monroe, GA (3-4 years) February 2009 - 2012 IT Coordinator/Help Desk Manager * Day to day troubleshooting, critical thinking, and problem solving with windows XP, windows 7, cellphones, Mac
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