Customer Service Authorization Specialist
Resume:
PROFESSIONAL SUMMARY
I'm hardworking, highly motivated professional eager to lend
combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs and increase service value.
EXPERIENCE
MRI authorization specialist
June 2015 - Present OrthopedicsNY, Albany, New York Processed prior authorizations requests within established time frames.
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Provided excellent customer service to patients via phone, email, or in person inquiries.
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Prepared and processed authorization forms for various insurance companies, ensuring accuracy of information.
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Get all STAT/Urgent authorization from all medical insurances for all radiology scans.
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• Enter detailed notes in chart related to authorization
• Managed our outsourced team, replied to emails and online training Work in close communication with doctors to get scans approved in a timely manner.
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Update authorizations if needed (CPT code change, facility change etc.)
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Answer authorization questions from rendering imaging facilities and hospitals.
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Entered data into electronic medical record system accurately and efficiently.
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Worked closely with internal departments to identify resolution strategies for denials and underpayments.
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Collaborated closely with clinical staff to ensure accurate coding of diagnoses and procedures.
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Followed up on all outstanding authorizations until they were approved or denied.
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CONTACT
ad4gje@r.postjobfree.com
Rotterdam, New York 12306
SKILLS
• Interpersonal Skills
• Critical Thinking
• Attention to Detail
• Multitasking Capabilities
• Time Management
• Problem Solving Abilities
• Organizational Skills
• Continuous Learning
• Resourcefulness
• Team Collaboration
• Insurance Verification
• Patient Advocacy
• Medical Terminology Expertise
• HIPAA Compliance
• Professionalism
• Empathy and Compassion
• Data Entry Proficiency
• Telephone Etiquette
• Microsoft Office
• Documentation and Reporting
• Document Preparation
• Multitasking
• Professional Demeanor
SHERRY ANN LUGO
INSURANCE AUTHORIZATION SPECIALIST
Patient Care Technician
February 2013 - May 2015 Ellis Bellvue women's Hospital, Niskayuna, New York
Ensured that all relevant documents were submitted correctly for each authorization request.
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Developed strong relationships with external customers, including insurance providers and medical offices.
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Analyzed patient records to determine eligibility for health care services.
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Tracked progress of pending cases through the authorization process.
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Assisted with appeals process when necessary by providing required documentation to insurance companies.
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Documented communications and contacts with clients in computer system.
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Successfully managed a caseload of 500-1000 authorizations per month while meeting all deadlines.
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• Performed hourly rounds and responded promptly to call lights. Monitored vital signs such as temperature, pulse rate, respiration rate and blood pressure.
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• Utilized computer systems for charting patient data. Assisted patients with eating, bathing, and grooming, supporting activities of daily living.
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Reported changes in patient status to nursing staff in a timely manner.
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Managed multiple tasks simultaneously while maintaining attention to detail.
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Responded promptly to emergency situations using established protocols.
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Assisted with patient transfers to and from wheelchairs, beds, and exam tables.
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Maintained cleanliness of assigned work area according to infection control standards.
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Participated in multi-skilled activities, supporting patient-centered approach to achieving desired outcomes.
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Inspected equipment to ensure proper functioning prior to use on patients.
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Organized patient information in an accurate and timely manner for medical records.
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• Collected specimens, such as urine, feces, and sputum. EDUCATION
Certification in Dental Assistant
August 2013
Hudson Valley Community College, Troy, New York
High School Diploma
• Goal Setting
• Interpersonal Communication
September 2005
West Demerara Secondary, South America
Certification in Computer network and cyber security August 2011
Schenectady County community college, Schenectady, New York REFERENCES
Kristin Dyer — OrthopedicsNY
Manager
ad4gje@r.postjobfree.com
Lisa Oconnell — OrthopedicsNY
Senior Director, Human Resources
ad4gje@r.postjobfree.com
Amber Smith — OrthopedicsNY
Supervisor
ad4gje@r.postjobfree.com
Previous Manager
Director At Previous Employer
Previous Supervisor
Contact this candidate