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Skills

  • Clerical support
  • Relationship development
  • Strong verbal communication
  • Inspection reviews
  • Data entry
  • Problem resolution
  • Proficiency in Asana
  • Medical terminology proficiency
  • Process implementation
  • Document scanning

Work Experiences

  • Was able to effectively respond to customer requests via phone and email, as well as answer questions and inquiries.
  • Kept up with labor market information and professional developments by visiting training providers, professional bodies, and employers.
  • Organized 11 mock interview seminars to help people improve their interviewing and communication skills.
  • Started two key partnerships that resulted in a 54% increase in revenue.
  • Double-checked the data's accuracy and integrity.
  • Used Tableau and Asana to keep track of the candidate files and notes for over 4 candidates.
  • Category helped me achieve $130,000.
  • Addressed client concerns within one year.
  • Examined departmental documents to determine how they should be distributed and filed.
  • Chose qualified applicants to refer to potential employers for job placement.

Summaries

  • Motivated professional capable of managing and monitoring member and group eligibility information.
  • Motivated Authorization Specialist with experience managing large-scale projects, including budgeting and administration.
  • Customer-focused Sales Representative with 8 years of experience solving problems for clients.
  • Achieved zero breaches in 2019.
  • Talented performer who has provided information, direction, and resource material for over 7 years.
  • Achieved results in the past year.
  • Achieved a 44% reduction in backlog cases.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the program business.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Looking for a new job that involves providing people with business support services.

Accomplishments

  • Resolved product issue through consumer testing.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Reviewed and processed over 10 authorization requests weekly, maintaining an approval accuracy rate of 58%.
  • Developed a system to track authorization denial trends, reducing denial rates by 79% over one year after recommendations were implemented.
  • Documented and resolved program which led to initiative.
  • Contributed to a new policy introduction for authorization improvement that led to a 47% reduction in overall service delays.
  • Reduced appeals case resolution time from 14 days to 11 days through efficient case organization and prioritization processes.
  • Collaborated with the billing department to resolve discrepancies in payer authorization requirements, resulting in a 70% improvement in claim acceptance.
  • Internally recognized for maintaining a 21% accuracy rate in processing insurance authorizations, exceeding departmental standards.
  • Implemented new eligibility verification protocols, reducing the authorization queue by 27% during high-volume periods.

Affiliations

  • Member of the American Health Information Management Association (AHIMA)
  • Affiliations with local Hospital Council committees for policy adaptations
  • Accredited member of the American Society of Authorization Specialists (ASAS)
  • Completed continuing education credits in Authorization & Revenue Cycle Management
  • Medical Administrative Assistant Certification (CMAA) through National Healthcareer Association (NHA)
  • Member of the Utilization Review Accreditation Commission (URAC)
  • Association for Supply Chain Management (APICS)
  • Affiliate membership with state-level Healthcare Compliance Association
  • Toastmasters
  • Member of the Case Management Society of America (CMSA)

Certifications

  • Certified Patient Registration Rep (CPRR)
  • Healthcare Financial Management Association (HFMA) Revenue Cycle Certification
  • Certified Professional in Healthcare Quality (CPHQ)
  • Certified Healthcare Risk Management (CHRM)
  • Apple Certified Associate (ACA)
  • Certified Healthcare Access Manager (CHAM)
  • Certified Health Data Analyst (CHDA)
  • Accredited Healthcare Security and Safety Officer (AHSSO)
  • Certified Specialist in Managed Care (CSMC)
  • Certified Public Accountant

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