Prior Authorization Customer Service

DAISY MEJIA

Avondale, AZ · 623-***-****

************@*****.*** · https://www.linkedin.com/in/daisymejia · I am a customer service specialist with over 10 years of experience. Self-motivated as well as goal- oriented individual with a strong desire to succeed. EXPERIENCE

OCTOBER 2020 – PRESENT

PAYER ANALYST, MCKESSON

Analyze payer trends and identify requirements by payer. Partner to create client facing reporting related to but not limited to payer changes. Monitor yearly drug coverage policy updates. Review, compile, and input data for client to ensure accuracy. Work with healthcare providers, patients, client to assist with prior authorization and appeal management for claim denials. Review case outcomes to analyze and identify insurance payment and denial trends. APRIL 2016 – SEPTEMBER 2016

CUSTOMER SERVICE, CENLAR

Assisting external customers with questions regarding their loan account. Processing payments, requesting payoff statements as well as provided explanations on account transactions. FEBRUARY 2015 – JANUARY 2016

PATIENT CARE, PHILIDOR RX SERVICES

Conducted outbound calls to provide insurance reimbursement support for clients. Processed refills on medications as well as payments. Researched JUNE 2013 – FEBRUARY 2015

CLAIMS TECHNICAL SUPPORT, GDIT

Provided assistance with comparisons on insurance plans and completed enrollments. Assisted with claims not limited to filing, interpretation and claim status. EDUCATION

MAY 2009

HIGH SCHOOL DIPLOMA, MILLENNIUM

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