Collections Specialist Prior Authorization
Resume:
Jay’Shawna Boone
Collections Specialist
Columbus, OH
********@*******.***
OBJECTIVE
Seeking to work in a dynamic institution where my superior organization and communication skills can add value.
EDUCATION —
EXPERIENCE
Thomas Worthington High School
04/2017-Present
Collections Specialist • Alliance Data
Analyze the customer’s financial situation and offer the best payment solutions.
Consistently perform to meet performance standards set by the department.
Place outbound collection calls on assigned accounts in their work queue, predictive dialer, and inbound calls.
Participate in monthly feedback sessions.
Ensure adherence to the Fair Debt Collections Practices Act and other compliance regulations, and security policies.
Successfully overcome stalls and objections.
Negotiated payment arrangements.
11/2014-04/2017
Quality Auditor • Express Scripts
Evaluated production processes for compliance with quality requirements.
Ensured compliance with regulations by reviewing and analyzing the cases of the Prior Authorization team for accuracy.
Communicated audit progress and findings by coaching the Prior Authorization Representative, preparing reports; and providing information in meetings.
11/2014-04/2017
Patient Care Coordinator • Express Scripts
Assisted 80-100 inbound and outbound members, providers, and physician calls per day in a busy call center environment.
Accurately obtained and entered patient information, including shipping, insurance, and payment information.
Provided patients with price quotes, order status, insurance verification and proof of deliveries.
Responsible for taking ownership of customer issues and ensuring 100 percent follow up to customers.
Processed all order changes including order cancellations, return authorizations, reships and requests for credit.
11/2014-04/2017
Prior Authorization Representative • Express Scripts
Managed inbound calls from pharmacists and doctors regarding prior authorizations by screening and reviewing requests based on benefit plan design, client specifics and clinical criteria.
Provided information to clients, participants, pharmacists and doctors regarding pharmacy benefits, drug coverage and perform accurate procedures for medication exceptions.
Collaborated with other associates and supervisors to ensure the best practices are shared.
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