Prior Authorization Specialist & Healthcare Coordinator
Resume:
Ebonee Gilliam
Phone: 520-***-****
Email: ******@*****.***
Professional Summary
Dedicated and detail-oriented Prior Authorization Specialist with over five years of experience in healthcare administration, insurance verification, and coordinating patient care. Experienced in collaborating with physicians, pharmacies, insurance companies, and multidisciplinary healthcare teams to ensure timely authorization of medical services and medications. Strong knowledge of medical terminology, healthcare workflows, insurance processes, and regulatory compliance. Recognized for exceptional customer service, organization, and the ability to manage multiple priorities in fast-paced clinical environments.
Core Qualifications
Prior Authorization Management
Insurance Verification & Benefits Coordination
Medical Terminology
Electronic Health Records (EHR)
Patient Scheduling & Care Coordination
Healthcare Compliance
Medical Office Administration
Customer Service Excellence
Communication & Relationship Building
Problem Solving
Time Management
Team Collaboration
Medical Records Documentation
Front Office Operations
Professional Experience
Pain Institute of Southern Arizona
Prior Authorization Specialist November 2020 – Present
Process prior authorization requests for medications, procedures, diagnostic testing, and medical services.
Communicate with insurance companies, physicians, pharmacies, and clinical staff to obtain timely authorization approvals.
Review medical documentation to ensure accuracy and compliance with payer requirements.
Track authorization requests, appeals, denials, and approvals while meeting established deadlines.
Maintain accurate patient records and documentation within the electronic medical record system.
Coordinate with multidisciplinary healthcare teams to ensure uninterrupted patient care.
Provide exceptional customer service while assisting patients with authorization and insurance-related questions.
Cross-Trained Medical Assistant September 2022 – Present
Assist providers with patient care and clinical workflows.
Document patient information accurately using electronic health records.
Support clinical operations while maintaining patient confidentiality and regulatory compliance.
Cross-Trained Front Desk Coordinator December 2023 – Present
Schedule patient appointments and coordinate provider calendars.
Verify insurance coverage and update patient demographics.
Manage incoming calls, patient check-in/check-out, and administrative duties.
Deliver professional customer service to patients and healthcare partners.
Catalunya Apartments – Biltmore Properties Inc.
Property Manager September 2022 – October 2022
Managed daily property operations and resident relations.
Oversaw leasing activities, documentation, and compliance requirements.
Coordinated maintenance requests and administrative functions.
Assistant Manager March 2020 – September 2020
Assisted with office operations, leasing, collections, and customer service.
Maintained resident records and processed documentation.
Catalunya Apartments – Paul Ash Management Company, LLC
Leasing Agent January 2019 – February 2020
Assisted prospective residents throughout the leasing process.
Prepared lease agreements and maintained resident files.
Delivered excellent customer service and administrative support.
Cascades of Tucson
Certified Caregiver July 2017 – January 2019
Provided compassionate daily care and support to residents.
Documented resident care and communicated changes to nursing staff.
Catalina Village Assisted Living
Administrative Medication Auditor February 2015 – May 2017
Audited medication administration records for accuracy and compliance.
Assisted with administrative reporting and healthcare documentation.
Collaborated with clinical staff to maintain regulatory standards.
Education
Certified Nursing Assistant (CNA) & Certified Caregiver
2009
General Education Diploma (GED)
State of Arizona 2000
References
Available upon request.
Contact this candidate