Prior Authorization Services Representative
Resume:
Leeland Perry
Columbus, OH *****
************@*****.***
Always willing to take on new responsibilities and learn something new. Authorized to work in the US for any employer
Work Experience
Fraud Analyst
JPMorgan Chase - Westerville, OH May 2022 to
Review all checks for possible fraud/money laundering and release checks that meet all criteria, make outbound calls to maker of check to confirm authenticity of check presented, create claim for all unknown debit card transactions, create and open new acct for customer reporting fraud, transfer all available funds to newly opened acct, review documents on file for trust accounts to make sure documents were received and uploaded to account profile, call branches to advise of fraudulent transaction, unlock and restore online access after passing high risk questions Member Services Representative
Molina Healthcare Inc - Columbus, OH February 2020 to Assist Members with updating address and doctors. Send request to have new member card issued. Calling Doctors offices to advise that a medication needs documentation to approve. Calling billing departments to have them stop billing the member. Locate a new doctor in their area. Work with doctors office to help member get approved for home health aide. Client Specialist Analyst
Express Scripts - Dublin, OH July 2019 to
Answer questions for the sales team and insurance companies. Resolve all issues and engage management when required. Provide accurate answers to all coverage questions. Call the insurance companies when required to approve cost overrides. Reach out to the doctors office when a prior authorization is required. Update copay amount per insurance companies approval. Patient Service Coordinator
Quantum Health - Dublin, CA July 2021 to March 2022 Assist provider and member with coverage, create approvals for surgery and procedures done in an office or hospital, advise of out of pocket and deductible amount met, Resolution expert
PCA - Dublin, OH August 2014 to July 2019
Help patients with refill orders and explain billing issues. Advise if the patients benefits require a prior authorization to approve medication. Assist doctors office to resolve any issue and schedule medication delivery. Follow up with doctors office with status of medication processing and delivery status. 02/09/2024
06/14/2020
014/10/2020
Complete prior authorization to approve patient for medication. Explain responsibility of balance from insurance and after copayment assistance has paid their portion of copayment. Work specialty project 340B. Program assist patient that qualify for lower income assistance. Send out weekly report for the 8 covered hospitals I am responsible for. Take on specialty projects as required. Help with training new team member with learning system and resolving issues. Education
Food Services Management
Columbus State
1986 to 1987
High school or equivalent in Basic
Dublin High School - Dublin, OH
1982 to 1986
Skills
• Customer Service Representatives
Judgment Collections
Tax
• HIPAA
• Insurance Verification
• Administrative Experience
• Medical Office Experience
• Medical Terminology
• Medical Billing
• Patient Care
• Medical Scheduling
• Teaching
• Leadership
• Data collection
• Phone Etiquette
• Office Administration
• Medical Records
• HIPAA
• Customer service
• Leadership
• Data collection
• Medical terminology
• Medical records
• Office experience
• Computer skills
• Communication skills
• Medicare
• Windows
• Microsoft Office
• Medical scheduling
• Typing
• Medical office experience
• English
• Anatomy knowledge
• Time management
• Classroom experience
• Working with people with autism
Links
https://www.linkedin.com/in/leeland-perry-6a90b223?jobid=1234&lipi=urn%3Ali%3Apage
%3Ad_jobs_easyapply_pdfgenresume%3B9DltV61sQHedC2mQx7g6Aw%3D%3D&licu=urn%3Ali
%3Acontrol%3Ad_jobs_easyapply_pdfgenresume-v02_profile Certifications and Licenses
Driver's License
Assessments
Sales skills — Proficient
March 2022
Influencing and negotiating with customers
Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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