Prior Authorization Specialist with 11+ Years Experience
Resume:
SUMMARY
Dacharmane Simmons
Detail-oriented Prior Authorization Specialist proudly offering over11 years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments.
SKILLS
************@*****.**
m Indianapolis, IN 46214
• Insurance Procedures
•Issue Research
•Understanding of Medical Terms
•CPT Codes
EXPERIENCE
• Records Maintenance
•Effective Communication Skills
•Proficiency in Microsoft Office
•ICD9 and ICD10
Prior Authorization Specialist
Indianapolis, IN
Volunteers of America of Ohio and Indiana/ Aug 2020 to Current
•Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
•Reviewed prior authorization requests have been reviewed to ensure accuracy and completeness of required information.
•Coordinated with other departments to obtain additional information needed for prior authorization.
•Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
•Processed appeals in a timely manner as per policy guidelines.
•Maintained accurate records of all authorization activities in the database system.
Customer Service Specialist
Indianapolis, IN
Ciox Medical Records Department/Jan 2016 to Aug 2020
•Answered incoming customer inquiries regarding product and service information.
•Performed data entry of customer orders into the company's order management system.
•Maintained a high level of professionalism while interacting with customers via phone or email.
•Followed up with customers after transactions to ensure satisfaction levels were met.
•Investigated escalated customer complaints utilizing problem-solvingskills to identify root causes of issues.
•Ensured compliance with all applicable laws related to consumer protection regulations.
Customer Service Representative
Indianapolis, IN
Ciproms Medical Billing/Jan 2011 to Jan 2016
•Answered customer inquiries and provided accurate information regarding products and services.
•Provided excellent customer service to resolve customer complaints in a timely manner.
•Performed administrative tasks such as filing paperwork, updating databases and generating reports.
•Resolved complex problems by working with other departments to provide solutions that meet customer needs.
•Developed strong relationships with customers by providing personalized assistance and support.
•Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
• Demonstrated excellent communication skills in resolving product and consumer complaints.
Customer Service Representative
Lebanon, IN
Pearson's Education/ Jan 2006 to Jan 2011
•Answered customer inquiries and provided accurate information regarding products and services.
•Provided excellent customer service to resolve customer complaints in a timely manner.
•Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
•Resolved complex problems by working with other departments to provide solutions that meet customer needs.
•Tracked orders from start to finish to ensure timely delivery of goods or services.
•De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
•Consulted with customers to resolve service and billing issues.
EDUCATION AND TRAINING
Associate of Science: Business Technology Bradford School of Business May 2004 Houston, TX
Contact this candidate