Data Entry Clerk

SUSAN KNIGHT-HUEY

******@*****.*** Home: Cell: 480-***-****

Work Experience

Care Review Processor February 2025 to Present

Molina Healthcare, Remote

• Process prior authorizations.

• Initiate authorization requests for outpatient and inpatient services.

• Extensive data entry, create and modify authorizations into the system.

• Ensure key performance indicators (KPI) and record collection metrics are met.

• Handle Medicaid, and Marketplace authorizations for Nebraska.

• Verifies member insurance coverage and/or service/benefit eligibility.

• Provide telephone, clerical, and data entry support for the Care Review team.

• Provides computer entries of authorization request/provider inquiries, such as eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination

• Responds to requests for authorization of services submitted via phone, fax, and mail.

• Contacts physician offices to request missing information from authorization requests or for additional information. Authorization Specialist II

Centene, Remote Sept 2022 to February 2025

• Process prior authorizations.

• Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list. Route to appropriate staff when needed.

• Verify eligibility and benefits in AHCCCS.

• Extensive Data entry, create and modify authorizations into the system.

• Ensure Key Performance Indicators (KPI) and record collection metrics are met.

• Call facilities and update status of outpatient observation patients.

• Handle Medicaid, and Marketplace authorizations for Arizona, Nebraska, Iowa, Florida, Indiana and Missouri.

• Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for documentation.

• Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment.

• Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer.

• Work on escalation team building authorization shells for biopharm.

• Contacts physician offices according to Department guidelines to request missing information from authorization requests. Transition Coordinator (Temporary)

CBRE – Amazon Account, Remote (Temporary Position – Amazon Account Ended) June 2021 to June 2022

• Reviewing and analyzing construction documents weekly in three file sharing locations to fulfill required Amazon document closeout process for 60+ projects.

• Recording collected document status with heavy data entry into excel, internal team database and Amazon file sharing browser application.

• Supporting Transition Manager with project status, required document modifications and advising on administrative improvements.

• Maintaining the 95% document closeout Amazon Service Level Agreement (SLA) to ensure Key Performance Indicators (KPI) and record collection metrics are met.

• Training new team members on the Amazon document closeout process and provide knowledgeable support. Administrative Assistant

Courtyard by Marriott, Everett, WA (Laid off due to Covid Impact on Hospitality) August 2019 to March 2020

• Provided administrative support to General Manager.

• Researched and prepared confidential HR data and performed data entry into designated database and forms.

• Worked within a variety of Human Resources systems and Microsoft programs to manage day-to-day responsibilities.

• Verified, updated, and corrected source documents.

• Performed accounts payable by coding and issuing checks to outside vendors.

• Audited and prepared payroll and HR-related functions utilizing ADP (Automatic Data Processing).

• Strong organizational skills performing Administrative Assistant, Human Resources and Housekeeping Supervisor roles. Loss Prevention and Safety Manager

Lowes, Monroe, WA (Position eliminated – Laid Off) June 2018 to February 2019

• Provided oversight and coaching of associates, analyzing sales trends, merchandising to improve profitability, and maintaining customer service expectations.

• Established process and controls that improved safety/hazmat, shrink and security outcomes.

• Oversaw and coordinated programs and processes to minimize loss while maintaining a safe working and shopping environment.

• Accurately input reports, inventory of merchandise and fixtures and data entry input into excel and Lowes’s file sharing browser applications.

• Gather weekly/monthly statistics, record data entry into database and create detailed reports to illustrate trends and successes. Asset Protection Lead

Rite Aid, Monroe, WA September 2014 to June 2018

• Defined problems, collected data, established facts, and drew valid conclusions.

• Accurately input reports, statistics, and inventory with data entry into Rite Aid internal database.

• Create and input agent weekly statistics in excel spreadsheet.

• Conducted operational audits in two districts consisting of fifty-six stores to ensure best practice compliance.

• Gathered weekly/monthly statistics, recorded data into database and created detailed reports to illustrate trends and successes. Skills

• Microsoft Office: Word, Excel, Outlook, PowerPoint • Confidentiality

• Data Entry • Interpersonal and intrapersonal communication

• Project management • Organization

• Database management and analysis • Problem solving and critical thinking.

• Multi-tasking

• Time management

• File Sharing

Education

South Mountain Community College, Phoenix, AZ – Courses in Criminal Justice Mesa Community College, Mesa, AZ – Courses in Criminal Justice Central Arizona College, Coolidge, AZ – Courses in Criminal Justice – Graduated Certified Police Officer University of Phoenix, Phoenix, AZ – Courses in Business Management

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