Prior Authorization Representative Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:

Experienced Prior Authorization Representative with excellent communication and customer service skills demonstrated by 10 years of experience in the prescription drug field as well as 8 years of telecommuting.

  • Understanding of Medicare and Medicaid processes
  • Maintains strict confidentiality
  • Managed care contract knowledge
  • HIPAA compliance
  • Strong work ethic

  • Excellent telephone etiquette
  • Abbreviations comprehension
  • Efficient and accurate
  • Team player with positive attitude
  • Strong problem solving ability
  • Troubleshooting skills
  • Microsoft Office proficiency

Managed prior authorization request for Dr's offices, hospitals, and nursing homes with up to 5000 request in the fax queue. Managed called flow with up to 100+ calls in queue. Several recognitions for employee of the month and vice president choice of the month.

Prior Authorization Representative, 10/2002 to 01/2013
Aetna Inc.Lansing, MI,

Provided accurate and appropriate information in response to customer inquiries.Demonstrated mastery of customer service call script within specified timeframes.Communicated directly with doctors' offices via telephone, fax and email.Verified patient data and billing information.Regularly completed paperwork and entered prescription and insurance billing information into patient profiles.Promptly referred all doctors’ calls and customers’ medical questions to the pharmacist on duty.

Customer Service Representative, 10/2002 to 08/2004
Old Second Bancorp, Inc.Chicago Heights, IL,

Answered inbound phone calls from patients and doctor's office. Refilled prescriptions and helped with billing and claim concerns.

High School Diploma: , Expected in 1992
North Caddo Magnet High - Vivian, LA

Education America-Medical Asst.

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Resume Strength

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Resume Overview

School Attended
  • North Caddo Magnet High
Job Titles Held:
  • Prior Authorization Representative
  • Customer Service Representative
  • High School Diploma

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