Prior Authorization Technical Support
Resume:
Makita Turner
Arlington,Tx
ad5wm1@r.postjobfree.com /
SUMMARY
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
SKILLS
Time Management
Insurance Information Oversight
Understanding of Medical Terms
Inbound/Outbound Calling
HIPAA
Great Work Ethics
Reliable & Trustworthy
Medical Terminology
Prior Authorization
Quickbooks
CRM
Zendesk
Multi-Tasking
People Skills
Telephone Etiquette
Flexible Schedule
Coding
EXPERIENCE
Prior Authorization Specialist / CVS Health - (Virtual) 02/2021 - 04/2023 Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures. Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients. Performed detailed medical reviews of prior authorization request, following established criteria and protocols. Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
Maintained files for referral and insurance information, entering referrals into system. Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer. Maintained strong call control and quickly worked through scripts to address problems. Engaged actively with callers, confirming or clarifying information and diffusing anger. Sales Associate / Prize Pest Control - Arlington,Tx 01/2019 - 02/2021 Helped customers find specific products, answered questions and offered product advice. Engaged customers in friendly, professional dialogue to determine needs. Answered incoming telephone calls to provide store, products and services information. Collected payments and provided accurate change.
Worked with fellow sales team members to achieve group targets. Answered product questions with up-to-date knowledge of sales and promotions. Developed trusting relationships with customers by making personal connections. Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items. Technical Support Associate / Straight Talk Wireless - (Call Center) 07/2016 - 01/2019 Provided technical support to customers by identifying causes of problems, researching and offering effective solutions. Recorded help desk calls by documenting issues, solutions and closing tickets. Identified and resolved issues using latest patches, releases, virus detection and troubleshooting techniques. Reviewed network data to check network usage, server function or disk space availability. Set up and configured wide area network (WAN) and local area network (LAN) routers. Determined causes of network issues by troubleshooting using testing software and equipment. Installed, maintained and repaired network software, components and equipment and integrated with existing system. Healthcare Customer Service Representative / Xerox 05/2013 - 07/2016 Utilized active listening and communication skills to address customer inquiries and escalate issues to supervisor. Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations. Provided helpful assistance by anticipating and responding to needs of patients and family members. Referred patients to appropriate professionals and services. Utilized technology and specialized software to maximize productivity. Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service. EDUCATION AND TRAINING
MT
High School Diploma
Warren Central High School
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