Prior Authorization Administrative Assistant
Resume:
Chippewa Falls, WI
Cell:715-***-****
E-mail ad5xyy@r.postjobfree.com
Stephanie Atter
Personal Details
I am seeking the position of Prior Authorization Claims II. While being outgoing, loyal, and clearly dedicated individual who has an ambition to succeed in any given environment. I have extensive experience in Customer Service, which includes Administrative Assistant, Prior Authorizations and Quality Insurance, escalated email research while providing outreach to providers. State level meetings reviewing SA determinations, as well as Denials. While providing support to our DME/Medical team, nurse reviewers, as well as any other department that requested help. Currently I handle complex situations with providers, which includes problem solving, with and without direction of leadership. Previous experience includes training other colleagues, as well as assisting the training department with visual aids for onboarding. I also have over 5 years client interface experience, emphasizing in Medical Prior Authorization Processes. I look forward to utilizing my experience and training, as well as my dedication, ambition, and loyalty to help make this team and department better.
Work Experiences
2023 - May – Present Gainwell Technologies
Senior Associate Customer Support
•Validate patient's insurance eligibility, as well as provider’s eligibility while entering SA’s into HE.
•Train other employee’s that assist in our department when our volume is high.
•Provider outreach when we receive escalated emails that providers submit for SA status and corrections. As well as respond to any questions that SOA may have pertained to individual SA’s. As well as reaching out regarding incomplete SA’s, and faxes that do not pertain to our area.
•Being a team player and problem solver to our team so that we may process our SA’s within our SLA.
•Handling complex situations when upper management is not available and making decision’s when needed.
•Also have helped in Customer Outreach department when they are uncertain with a status of a SA.
•Created power points for Onboarding regarding the SA Department.
•Completing reports, as well as researching any prior authorization concern’s that we must stay within SLA.
•Working independently with little to no supervision, while handling high workflow. Making critical decision’s while reviewing, and approving SA’s.
•Currently active in the DSM SA process for DME Medical, as well as monthly testing for Conduent – HCS – HMS Collaborative.
2021 - August – 2023 - March Artech Inc./Medtronic
Prior Authorization Representative Specialist
•Validate patient's Insurance eligibility benefits using Emdeon and Availity.
•Verify Insurance requirements for Prior Authorization’s and initiate or request additional information as required.
•Working directly with the Physician's offices and payers, I submitted authorizations and assisted with appealing authorization denials.
•Coordination of required paperwork which included clinical notes, and Insurance specific Prior Authorization forms.
•Frequent follow ups were also expected to ensure visibility on the authorization status throughout the approval process.
•Inputting ICD 10 and CPT Codes, patient information and insurance details were done in AMD, and running determination letters.
•Training new employees to learn daily tasks.
Education
November 2023 – Present University of Arizona Global Campus Online
Currently studying for my BA in Bachelor of Arts Program, with a major in Health Care Administration.
Within 5 years I see myself in a position within the company as a DME/Claims Manager.
June 2023 – October 2023 EdX Online
While attending EdX I studied different body anatomies, and past the Certification test to receive a Medical Terminology Certificate.
Spring 2009 Globe University Eau Claire, WI
4955 Bullis Farm Road 715-***-**** GPA 2.5 – Made Dean's List
While attending Globe University, I studied Economics, Technical Writing, Business Math and other minor classes.
I completed only one semester with great accomplishment of making the Dean's List. After the quarter was done, I could no longer go back due to funding issues. I am currently applying to finish my Associate In Business Administration in the fall online.
2003-2004 Chippewa Valley Technical College Eau Claire, WI
Industrial Engineering
While currently enrolled in this program, I have completed the following program that is related to Quality, Processes, and teams. I choose this field due to being laid off from Honeywell, in Chippewa Falls WI, while working in the Quality Department, and dealing with processes, and specs of customers.
Classes that I completed are Inventory Control, Economics, Sociology, Safety in the Workplace, Managing for Quality, CAD Basic I, Engineering Economy, Project Management, Manufacturing Materials Processes, Principles of Industrial Engineering, Facility Layout and Material Handling.
1989-1991 Chippewa Valley Technical College Eau Claire, WI
Diploma in Financial Services Assistant
I was trained on how to become a Bank Teller, dealing with cash in and cash out. Advanced training included completing Loan Applications, as well as verifying credit background scores.
Some of the classes that I have completed were Accounting, Banking Laws and Rules, and your normal classes like Math and English.
With this program, I also received a minor in Data Entry and computer software programs. While working for this degree, I learned how to set up programs for data entry in a business form. Some examples would be order taking for a catalog department store. I currently have a 70 stroke per minute.
Skills
Prior Authorization Specialist, excellent communication skills both verbal and writing. excellent customer relation skills, call center, Epic, customer service, Provider outreach, email escalations, insurance verification, DSM emails, created training power points for onboarding, and Microsoft Office. Working well with others without supervision, taking directives from upper management, and multi-tasking a variety of job functions, and can work in a fast-paced environment and a positive member of all teams. I have also completed classes in G Force, and Gainwell University, and currently enrolled in UAGC to receive my BA in Healthcare with a goal to become a Claims Manager. I am always eager to expand my knowledge and go the extra step to help out our department.
References
Linda Curtis (Friend): Eau Claire, WI 715-***-****.
Khadija Wiley (Co Worker) 226 Dorchester Dr F15 East Windsor NJ, 08512 908-***-**** (ad5xyy@r.postjobfree.com)
Joy Kallestad (Previous Medtronic Supervisor) 7000 Central Ave NE, Minneapolis MN 55432 612-***-**** (ad5xyy@r.postjobfree.com)
Holli Matsuda (Sr Training Specialist) Gainwell Technologies 906-***-**** (ad5xyy@r.postjobfree.com)
Northey, Kimberly ( BPS Alaska Ops Customer Support) Gainwell Technologies907-903-0275 (ad5xyy@r.postjobfree.com)
Michelle Coltrane (Former HMS Gainwell Nurse) 1-907-***-****
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