Central Authorization Specialist Resume Example
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CENTRAL AUTHORIZATION SPECIALIST
Professional Summary
Offering 10+ years of experience and willingness Enthusiastic [Job Title] eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of [Task] and [Task] and training in [Skill]. Motivated to learn, grow and excel in [Industry]. Trained in [Software] use and administration with knowledge of [Area of expertise]. Dedicated to excellent customer service and best-in-class collaboration.
Skills
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Work History
Baycare Health System, IncCentral Authorization Specialist | Brooksville , FL | May 2017 - Current
- Insurance verification, procure pre-authorization for outpatient ordered services
- Verifying authorization requirements through payer portal and payer grid
- Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes
- Communicate data with clinical staff to ensure that services are provided within parameters of authorization.
- Create, manage and maintain referrals for accuracy.
- Review medical records in Epic for retrieval for authorization submission.
- Identified important patient and demographic information.
- Gathered information to file appeals for denials and minimized inaccuracies by maintaining accurate records of approvals.
- Address, document, and respond to incoming and outgoing calls and correspondence.
Canyon View Medical GroupPatient Account Representative | Santaquin , UT | September 2016 - May 2017
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Reviewed medical records to meet insurance company requirements.
- Posted payments and processed refunds.
- Processed and managed insurance appeals.
- Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
- Verified final claim submissions by comparing account charges with documentation.
- Addressed and responded to provider inquiries regarding CPT and diagnosis codes
- Added modifiers, coded narrative diagnosis and verified diagnoses.
- Utilized electronic charge capture systems to consolidate and streamline billing processes.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Reviewed account information to conform patient and insurance information is accurate.
Amerisourcebergen Corporation - CorporateBilling Specialist I | Richmond , VA | January 2015 - September 2016
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Executed billing tasks and recorded information in company databases.
- Verified insurance and demographic information ensuring claims were sent to player accurately.
- Analyze accounts to discover discrepancies and resolve variances.
- Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
- Verified proper ICD-10 coding and procedure codes on claims.
- Researched and followed up on denied insurance claims.
Trinity Health CorporationUnit Secretary | Detroit , MI | October 2009 - Current
- Supported office staff and operational requirements with administrative tasks.
- Organized paperwork such as charts and reports for office and patient needs.
- Developed training protocols for new unit secretaries.
- Enhanced office productivity by handling high volume of callers per day.
- Maintained rapport with all unit staff, including physicians, nurse and other healthcare personnel.
- Monitored and managed patient census for high volume, outpatient nursing unit.
News America MarketingMerchandiser | October 2018 - December 2020
- Completed seasonal windows, dressed mannequins and arranged displays according to in-store planograms.
- Promoted seasonal products and trends to move stock and prepare for incoming inventory.
- Communicate key finding in daily visits/weekly through store reports to account manager.
Education
Associate of Applied ScienceInterior DesignBaker College City, State | June 2001
Certifications
Certified Medical Billing and Coding Specialist ( CBCS)- National Health Care Association.-2015
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Resume Overview
School Attended
- Baker College
Job Titles Held:
- Central Authorization Specialist
- Patient Account Representative
- Billing Specialist I
- Unit Secretary
- Merchandiser
Degrees
- Associate of Applied Science Interior Design
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