Prior Authorization Specialist

ELIZABETH

FERRELL, LPN, PACS

SUMMARY

HARDWORKING PRIOR AUTHORIZATION SPECIALIST WITH SUCCESSFUL BACKGROUND WORKING CLOSELY WITH INSURANCE COMPANY RESPRESENTATIVES TO GAIN PRE-APPROVAL FOR MEDICATIONS.

DETAIL ORIENTED PERFORMER WITH OVER 32 YEARS OF MANAGING DOCUMENTATION. CONSIDERED TEAM PLAYER WITH EXEMPLARY MULTITASKING SKILLS

EXPERIENCE

COMMUNITY CLINICS OF NORTHWEST ARKANSAS – 610 E EMMA AVE, SPRINGDALE, AR 72764

*LEVERAGED E-CLINICAL SKILLS TO INPUT AND COMPILE DATA GATHERED FROM VARIOUS SOURCES.

* MAINTAINED UPDATE KNOWLEDGE THROUH CONTINUEING AND ADVANCED TRAINING.

*PERFORMED DETAILED MEDICAL REVIEWS OF PRIOR AUTHORIZATION REQUEST, FOLLOWING ESTABLISHED CRITERIA AND PROTOCOLS.

*ENSURED COMPLIANCE WITH STATE AND FEDERAL REGULATIONS PERTAINING TO PRIOR AUTHORIZATIONS. COORDINATED RESOLUTIONS FOR USSUES AND APPEALED DENIAL AUTHORIZATIONS.

APPLIED KNOWLEDGE OF MEDICARE, MEDICAID AND THIRD-PARTY PAYER REQUIREMENTS UTILIZING ON-LINE ELIGIBILITY SYSTEMS TO VERIFY PATIENT COVERAGE AND POLICY LIMITATIONS.

CLIENT CARE MANAGER – HUMANA/BRIGHTSTAR – 4262 FRONTAGE RD FAYETTEVILLE, AR 72703 479-***-****

*ACTIVITIES AND HOBBIES

2609 Featherstone Rd Apt 233

Oklahoma City, OK 73120

479-***-****

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

COORDINATED SERVICES FOR CLIENTS BASED ON INDIVIDUAL NEEDS BY MATCHING CLIENTS WITH SERVICES.

*ACTED AS CONSULTANT TO COMMUNITY PROGRAMS BY INTERPRETING REGULATIONS AND POLICIES.

*ESTABLISHED AND MAINTAINED RELATIONSHIPS TO MEET COMMUNITY NEEDS AND AVOID SERVICE DUPLICATIONS.

*CROCHET ENTHUSIST

*FRENCH HORN PLAYER

* LGBTQ ADVOCATE

ACCOMPLISHMENTS

EMPLOYEE OF THE MONTH FOR COMMUNITY CLINICS NWA

EMPLOYEE OF THE MONTH FOR HUMANA/BRICKTSTAR

CERTIFICATIONS

*LICENSED PRATICAL NURSE

*PRIOR AUTHORIZATION CERTIFICATION SPECIALIST

*CPR

REFERENCES

REFERENCES AVAILABLE UPON REQUEST