Authorization Specialist with 5+ Years of Experience

Tiaisha Thomas

Vicksburg, MS 601-***-**** *******.******@*****.***

Professional Summary

Authorization Specialist with 5+ years’ experience driving efficient prior authorization and insurance verification for high- volume clinical teams. Expert in clinical documentation review, workflow optimization, and cross-functional collaboration

— consistently streamlining processes and identifying cost-saving alternatives to expedite patient access to care. Willing to relocate: Anywhere

Work Experience

Authorization Specialist

Healthcare Support

September 2024 to January 2026

• Obtained prior authorizations to ensure timely patient access to necessary treatments and procedures.

• Verified patient eligibility for healthcare services, maintaining accuracy in processing requests.

• Communicated effectively with payers and healthcare providers to facilitate smooth authorization processes.

• Documented and tracked authorization records to ensure comprehensive and organized data management.

• Managed denial and appeal processes, working to resolve issues and secure necessary approvals.

• Ensured compliance with healthcare regulations and payer requirements to maintain service standards.

• Conducted insurance verification to confirm coverage and prevent service disruptions.

• Acted as a communication liaison between patients, providers, and insurance companies to clarify procedures.

• Followed up on pending authorizations, maintaining proactive communication to expedite approvals. Prior Authorization Specialist

BroadPath Healthcare Solutions WFH Tucson, AZ

July 2023 to August 2024

• Verified and secured prior authorizations from insurance providers, ensuring compliance with medical service requirements and facilitating patient access to care.

• Researched and resolved account discrepancies related to authorization information, collaborating with clients, insurers, and internal stakeholders to guarantee precise and prompt claims processing.

• Documented patient eligibility, benefits, and authorization particulars, maintaining adherence to established healthcare documentation standards and contributing to operational efficiency. Customer Service Representative

Alorica Saint Joseph, MO

September 2017 to June 2023

• Managed high-volume call flow, averaging 100-200 daily calls, effectively routing inquiries to appropriate departments for efficient resolution.

• Assisted clients with inquiries regarding medical care, benefits, and provided necessary information, ensuring customer understanding and satisfaction.

• Addressed and resolved patient insurance claims, billing discrepancies, and service complaints, escalating complex issues to management when required.

• Conducted outbound follow-up calls to evaluate service experiences and communicated service changes, enhancing customer engagement and care continuity.

Customer Service Representative

Conduent Business Services, LLC (Formerly Xerox) Madison, MS October 2016 to July 2019

• Addressed customer inquiries and resolved issues, ensuring high standards of customer service and satisfaction were consistently maintained.

• Collaborated effectively within team settings and demonstrated autonomy in individual projects, showcasing a balance of teamwork and independent work ethic.

• Utilized advanced research skills to gather information and provide informed responses, enhancing the overall quality and efficiency of customer support.

Education

Psychology (Bachelor's degree)

Belhaven University

High school diploma

Wingfield High School

May 2009 to May 2009

Upper secondary education

Skills

• Medical billing expertise • EMR systems • Regulatory compliance • Authorization approvals • Healthcare management • Patient relations • Insurance verification • Process optimization Languages

Bilingual

English

Certifications and Licenses

Health Insurance License

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