Prior Authorization Customer Service

Angela Legates

*** * ******** **

Dover, DE *****

Cell 302-***-****

************@*****.***

Education

**/****-**/****: Grand Canyon University

Bachelor of Science in Psychology

**/****-**/****: PolyTech High School Medical Coding Certification

Experience

2016-2017 United Health Group, Remote Work from home agent, Clinical Administrative Counselor

Skills

Call providers with determination status of prior authorization requests

Scrub prior authorization cases for accuracy

Contact providers to request clinical documentation to support prior authorization request

Send, receive, and attach faxes both clinical and notifications

Assist in training agents not meeting goals and new hires

Training on new skills or programs necessary for everyday practices

Answer policy/best practice questions for the team as back up for our SME.

Experience with CareOne, ICUE, RightFax

2015 Pearson Education formerly Xerox, ASU Online, Remote Work from home agent, Enrollment Counselor

Skills

Complete discovery calls to qualify potential students to college

Walk student through steps of the application process

Follow up with students to manage tasks to complete to continue the enrollment process

Advise students on enrollment decision and potential steps to take if not admitted

If admitted assist with registering for the first round of classes

Assist students via chat and email

2011-2015 Bank of America, 655 Paper Mill Rd Newark DE, Customer Service & Sales Small Business

Skills

Take customer calls for servicing their business accounts

assist with online banking issues

Sell additional services such as additional accounts, credit cards, business services, and the merchant or payroll services.

train new hires and associates not meeting full potential

Coaching

training

providing feedback

taking escalated customer calls.

Experience with Boss/Fast, Interact, Tsys, Compass, Lean, Clics, Bass.

Achievements

Numerous compliment calls and recognition awards for customer service and helping teammates, peer coaching.

2000-2011: Curtiss Landing/Penny Pinchers S. Governors Ave Dover, DE, Shift Runner/Store Manager

Skills

Store manager

I delivered pizzas some when needed

Completed deposits

Scheduling

produced all of the menus and made order forms for the new business

produced all marketing documents for business

assisted in the implementation of new marketing dispersal.

handled customer complaints

Routing/dispatching drivers

Train associates

2009-2011 Comcast Cable Dover DE, Newark DE, Connection Specialist, CAE/Team Coach

Skills

Sold services in a retail location.

Took customer calls for billing, collection, service, etc.

Schedule appointments

Team Coach position that had me help others around me by answering questions, closing work orders, sending signals to reset equipment

performed quality assessments for calls for all of the department

taking manager calls

Did all aspects of manager duties.

Training associates

Achievements

Within the first couple of months already had supervisor roles.

2007-2008 Phoenix Behavioral Health Beaver Brook Plaza New Castle, DE, Office Manager

Skills

Office Manager

I checked in/out the patients

complete end of night deposits

answer phones

Filing

Scheduling.

Medical billing

inbound and outbound collections

Skip tracing

Managed satellite office worked independently for all administrative duties

Work with teammates in the primary location

2007-2008 Halpern Eye Assoc. 885 S. Governors Ave. Dover, DE, Medical Technician

Skills

take medical history

pre-test for exams

contact lens fittings

Vision assessment

visual field testing

applanation tonometry

neutralize glasses prescription

refraction skills

Medical billing, inbound and outbound collections

Skip tracing.

Training associates

Volunteer/Accomplishments

Graduated Magna Cum Laude 2016

Member of National Honor Society since 2015

Member of Alpha Chi Honor Society since 2015

Member of Psi Chi Honor Society since 2015

Volunteer work and experience with Domestic Violence 4+ years

Volunteer work and experience with Homeless Programs 10+ years

Volunteer work and experience with church youth group, children’s ministry & nursery 4+ years

Read Aloud Delaware

Delegate for Court of Chancery Guardianship Program

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