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Skills

  • Fraud Prevention Protocols
  • Regulatory compliance
  • Authorization process automation
  • Customer dispute resolution
  • Continuous process improvement initiative
  • Workload prioritization
  • Team building
  • Employee onboarding improvement
  • Decision-Making Efficiency Enhancement
  • Budgets

Work Experiences

  • Consistently met regulatory deadlines.
  • Looked for industry trends on social media and through online sources.
  • Achieved results within the first quarter of implementation.
  • Achieved zero missed SLAs.
  • Analyzed historic authorization data.
  • Avoided delays in procurement.
  • Achieved initiative for operational excellence.
  • Collaborated with cross-functional teams.
  • Achieved improvement over six months.
  • Analyzed bottlenecks in the approval process.

Summaries

  • Achieved a 66% decrease in procedural inconsistencies.
  • Within Miscellaneous, senior Complex Authorization Specialist and outstanding performer in quality assurance and data analysis.
  • Accomplished Complex Authorization Specialist skilled in cross-functional team leadership and workflow optimization, recognized for improving authorization completion by 52% within one year.
  • Achieved improved performance across multiple KPIs.
  • Achieved 21% accuracy in high-volume request processing.
  • Collaborated effectively with external stakeholders.
  • Achieved results within the past year.
  • Achieved a 67% resolution rate.
  • Customer service is a strong suit, as is keeping conflict resolution focused on the client.
  • Achieved a 22% reduction in average authorization processing errors.

Accomplishments

  • Standardized the company’s multi-party authorization process, improving workflow efficiency by 37% within 3 months.
  • Implemented a pre-authorization screening algorithm that reduced the chances of errors during final authorization checks by 76%.
  • Redesigned the authorization escalation process to prioritize risk cases, decreasing average case resolution times by 9 days.
  • Collaborated with the IT department to introduce a new tool allowing real-time tracking of authorization requests, cutting the review process time by 43%.
  • Spearheaded a project to integrate Asana that allowed for real-time updating of authorization status, reducing customer wait time by 40%.
  • Optimized client communication protocols during the authorization process, resulting in a 52% reduction in response times.
  • Mentored a team of 5 junior specialists on authorization best practices, reducing entry-level errors by 62% within 13 months.
  • Advised leadership on authorization risk mitigation strategies, resulting in a 72% improvement in error-prevention efficiency.
  • Influenced a 44% increase in client satisfaction by implementing clearer communications during the complex authorization process.
  • Successfully reduced employee escalations related to authorization processes by implementing cross-department knowledge-sharing platforms, reducing errors by 76%.

Affiliations

  • Volunteer at National Patient Advocate Foundation with 18 years of service
  • International Association of Administrative Professionals
  • Certification through Six Sigma Green Belt 2018
  • Provider login access to the National Healthcareer Association (NHA) continuing education resources
  • Affiliation with Credentialing Resource Center (CRC)
  • Member of American Academy of Professional Coders (AAPC)
  • Member of the Society for Human Resource Management (SHRM)
  • Affiliation with National Association of Insurance Commissioners (NAIC)
  • Association for Computing Machinery
  • Project Management Institute

Certifications

  • Certified Healthcare Access Manager (CHAM) from the National Association of Healthcare Access Management (NAHAM)
  • Certified Healthcare Compliance Associate (CHCA) from the American Institute of Healthcare Compliance (AIHC)
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified in Healthcare Compliance (CHC) from the Health Care Compliance Association (HCCA)
  • Certified in Health Informatics (CHI) from Meridian, 2015
  • Project Management Professional (PMP)
  • Certified Regulatory Compliance Manager (CRCM) from the American Bankers Association (ABA)
  • ServSafe
  • Apple Certified Associate (ACA)
  • CompTIA Security+

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