Prior Authorization/Medical Benefits Coordinator

PAMELA PRIMO

**** ******* ** #***, **********, GA 30052 H: 678-***-**** ***********@*****.***

PROFESSIONAL SUMMARY

Deadline driven Prior Authorization Specialist with accredited training in clinical and laboratory procedures as

well as 6+ years honing medical billing skills on the job. Strong attention to detail and extensive knowledge of

medical terminology. Thorough understanding of contract, medicaid and medicare reimbursement terminology.

PROFESSIONAL EXPERIENCE

Prior Authorizations Coordinator

04/2014 to Current

Elab Solutions Atlanta, GA

Acquired insurance authorizations for procedures and tests ordered by the attending

physician.

Completed appeals and filed and submitted claims.

Thoroughly investigated past due invoices and minimized number of unpaid

accounts.

Remained up to date with all insurance requirements, including the details of

patient financial responsibilities, fee for service and managed care plans.

Demonstrated knowledge of HIPAA Privacy and Security Regulations by

appropriately handling patient information.

Benefits Verification Coordinator

03/2009 to 04/2014

Omi Diagnostic Atlanta, GA

Efficiently performed insurance verification and pre certification and

pre authorization functions.

Prepared and attached all required claims documentation including referrals, prior

authorizations or other required correspondence to reduce incidence of denials.

Consistently informed patients of their financial responsibilities prior to services

being rendered.

Monitored shared email in boxes and ensured inquiries were addressed.

Ability to multi task and work in a fast paced environment.

Spot Billing Analyst

09/2005 to 08/2007

Resources USA/GM Plan Works Group New York, NY

Process electronic radio, television and cable invoices for client payments, ensuring

they were paid on time.

Responsible for batching, coding and inputting hard copy invoices into Donovan

Data System.

Maintain billing summary spreadsheets and run weekly reports for Media Buyers for

open items.

Work with stations and buyers to resolve billing discrepancies and payment issues.

SKILL HIGHLIGHTS

Knowledge of HMOs, Medicare and MS Word, Excel, and Outlook

Maintains strict confidentiality

Medi Cal

Deadline driven

Electronic Medical Record (EMR)

software

Medical terminology and CPT coding

experience

EDUCATION AND TRAINING

Javelin Tech Tucker, GA

2009

Coursework in Healthcare Management,Coursework in Medical Assisting

Medgar Evers College Brooklyn, NY

2004

Business Administration, Emphasis in Finance

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