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Administrative Assistant Prior Authorization

Location:
Olney, MD
Posted:
July 14, 2023

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Resume:

EXECUTIVE ASSISTANT ADMINISTRATIVE ASSISTANT

Ambitious and detail-oriented professional with 13 years of experience in administration. Seeking an executive or administrative assistant position with CareMore and Aspire Health. Outstanding communication skills. Fast learner and team player. Experience supporting several current CareMore leaders.

- CORE STRENGTHS -

* Administration *Time Management * Process Improvement

* SharePoint * Project Management * Detail-Oriented

* Medical Terminology * MS Office/ Excel/ Power Point * Slide Deck Presentation

* Chrome River * GetThere Travel *Workday

* Working on Certified Administrative Professional Certification (CAP)

* Working on International Administrative Professional Certification (IAP)

- PROFESSIONAL EXPERIENCE –

Administrative Assistant II Aug 2021-Present

CareMore Health / Elevance, Olney, MD

Currently supporting the MSO Staff VP, Managing Medical Director UM of Utilization Management, and two Director IIs

Responsible for time management of Staff VP based on business priorities and timelines, including starting meetings for executive if running behind schedule, reschedule meeting conflicts as soon as they occur

Manage projects and deliverables assigned to team by creating a tracking timeline and following up with task owners

Assisting with the WorkIQ project that involves over 250 MSO associates. This includes being the Administrator and liaison between CareMore and WorkIQ to make sure all managers are trained, submit IT tickets on behalf of staff, along with keeping track of progress

Assist MSO Department in submitting, tracking, and managing all IT Service Connect tickets, while ensuring they are completed in a timely manner

Serve as primary contact for scheduling interviews and onboarding new leaders such as ordering equipment, submitting software IT tickets, badges requests, and scheduling introduction meetings with key leaders

Created 3+ Microsoft Teams group sites to manage internal reporting and keep files in one location for teams to review and update

Attend department meetings to gather takeaway items and meeting minutes.

Organize travel for leaders via GetThere Travel. Decrease travel expenses by 15% with resourceful booking techniques, along with provided leaders with eligible upgrades and accommodations that are within company policy

Serve as primary contact for scheduling interviews and onboarding new Leaders

Experience with creating expense reports via Chrome River for Leaders who have been on travel or need other company policy expenses submitted

Experience with assisting Leaders with Workday tasks, such as approving PTO request

Executive Administrative Assistant Jul 2017- Dec 2020

Leisure World of Maryland Corporation, Silver Spring, MD

In this senior living facility, I served as customer service representative by taking calls, close out service invoices each month, scheduling maintenance appointments

Designated as Executive Administrative Assistant

As EA, was the liaison between Executive Leaders and PPD Executive Administrative Team.

Organized Monthly Town Hall Meetings for Executives to meet with over 40 staff members and shareholders

Negotiated favorable terms and pricing agreements with contractors, vendors, tradesmen, and other providers for service.

Improved office efficiency by implementing a paperless filing system and introducing additional time-saving measures

Administrative Assistant I Oct 2014-Jul 2017

Target Community and Educational Services, Gaithersburg, MD

Provided efficient and effective administrative support and executive assistance within Target Community which is a fast-paced environment whose objective was to provide services to adults with disabilities and their families. Served as backup and cross-trained in various organizational processes that spanned across new employee training, human resource, and payroll processes along with inventory and accounts payable.

Responsible for scheduling high level meetings for SVP and SLT

Effectively managed and maintained all organizational schedules, meetings and events including providing personalized support to executive stakeholders

Initial point of contact and navigated in-take processes for all organization guests, clients, and other stakeholders

Served as an Assistant to human resource processing all new employee on-boarding, orientations, training, employee handbook development and payroll processes.

Accountable for overseeing and maintaining client IEP records

Coordinated the execution of all staff trainings to ensure quarterly trainings for our agency stay within county compliance and state regulations

Liable for the receipt of all medications on behalf of the organization and ensured proper quality checks and inventory was completed for the medication receipt process.

Maintained, filed, and organized all staff and organizational records including human resource and personnel records, state and county certifications, individual licenses, and compliance records for all client services activities

Reimbursement Case Advocate Apr 2007-Apr 2013

The Lash Group, Rockville, MD

Throughout my six years at The Lash Group, I was a part of 4 different medical teams and worked under the supervision of 6 direct supervisors and several other management team members. My positions consisted of several different administrative tasks

Served as Reimbursement Case Advocate II, which consists of receiving and documenting incoming calls from medical providers and patients.

Case management

Reporting benefit investigation results and prior authorization outcome to both medical providers and patients

Confirmed medical providers, nurses, and patients have a good understanding of benefits, prior authorization results, and program policies and procedures via phone conference.

If requested by medical provider, I would schedule patients for medical pre-screening exams and ensure all pre-screening exams have been completed and reviewed provider.

Obtained First Dose Observation clearance from provider, then scheduled observation for the patient, complete all documents and finalize shipment of medication finally followed up with the provider two days after the First Dose Observation and confirm the Observation was successful

Acquired permission to release the patients Rx to specialty pharmacies. Also followed up with Specialty Pharmacies to obtain status of Rx.

If the patient needed any financial assistance to obtain Rx, I would be responsible for facilitating this to the patient

Ensured that the patient has received their first shipment of Rx and they know how to obtain monthly refills

Followed up on Canceled/Discontinued cases and find the reasoning. If needed I would re-open the patient's case

Spanish Speaking translator for the program.

Reimbursement Specialist II Jun 2011-Feb 2012

Makena Care Connection, Gaithersburg, MD

Received incoming calls from medical provider's offices and patients who wanted to apply for medication regarding high risks pregnancies

Performed medical and pharmacy benefit investigations to verify is a prior authorization is required

Reporting benefit investigation results to medical providers and patients

Confirmed that both medical providers and patient have a good understanding of benefits

Submitted referral to specialty pharmacy for their review

As Needed, I was responsible for screening patients for eligibility of Patient Assistance Program (PAP), Urgent Initiation of Therapy (UIT), and Continuation of Therapy Programs (COC)

Spanish Speaking Translator

Senior Benefit Investigator Jan 2009 – Jun 2011

Humatrope, Gaithersburg, MD

Performed medical and pharmacy benefits investigations

Verified if a prior authorization is required or needed. Completed needed forms and submitted them to insurance companies

Obtained prior authorization forms and medical documentation from the doctors’ offices as needed

Followed up with insurance companies regarding prior authorization status

Contacted specialty pharmacies to verify who will pursue the re-certification process or prior authorizations

If needed verified benefits for re-certification cases and follow SOP procedures to complete cases

- EDUCATION & PROFESSIONAL DEVELOPMENT-

Col Zadok Magruder High School Jun 2003

Rockville, MD

Bootcamp Sept 2003

Great Lakes, United States Navy



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