Medical Authorization Specialist Resume Example

Love this resume?

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000,
Professional Summary
Prior Authorization Specialist with 8 years experience in the medical field.  Excellent communication and customer service skills.  Detail-oriented and focused on accuracy and efficiency.
Skill Highlights
  • Knowledge of ICD10 codes/CPT codes
  • Excellent communication and customer service skills
  • Bilingual in Spanish/English
  • HIPAA trained
  • Medical terminology knowledge 
  • Proficient in Microsoft Windows, Office, Word, Outlook, Power Point and Excel
Professional Experience
07/2015 to Current Medical Authorization Specialist Bioventus | Miami, FL,
  • Obtain authorizations from health insurance, worker's comp, amongst other payors for MRI, CT and NUC MED.
  • Update patient demographics and insurance information.
  • Daily interaction with other departments to assist patients and providers with problems or questions and act as a facilitator to resolve questions or concerns.
09/2010 to 05/2016 Pharmacy Service Associate Lincare | Duluth, GA,
  • Assisted providers initiating and completing prior authorizations for patient medications.
  • Provided customer service to members, providers and pharmacist with authorizations status, reconsiderations, appeal process, and medication overrides.

Customer Service Rep

  • ​Educated Spanish/English speaking members  on how to take advantage of their benefits in a fast paced environment.
  • Provided claim status to members and providers.
  • Researched issues and provided resolutions if applicable.
  • Provided medical/dental benefit details to members and providers.
  • Enrolled new members and made changes to existing medical/dental plans.
10/2007 to 09/2010 RX Enrollment Specialist Humana Healthcare | City, STATE,
  • Acted as a facilitator for members in resolving questions or concerns regarding their medications.   
  • Provided customer service to members with prescription refills.
  • Outbound soft sales calls.
  • Assisted with delegated agents calls with data entry.

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:


Resume Strength

  • Formatting
  • Length
  • Personalization
  • Target Job

Resume Overview

School Attended
    Job Titles Held:
    • Medical Authorization Specialist
    • Pharmacy Service Associate
    • RX Enrollment Specialist

      Similar Resume

      View All
      Authorization Specialist / Medical Biller
      Medical Billing Specialist /Authorization Coordinator
      Medical Assistant Triage/Prior Authorization Specialist