Brittany Arnold
Prospect
Summary
Hardworking and knowledgable Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for prescriptions. Considered team player with exemplary multitasking skills. Hardworking, passionate job and detail oriented team player with strong organizational skills used to help teams achieve company goals.
Overview
12
12
years of professional experience
Work History
Prior Authorization Specialist
CareMed Specialty Pharmacy/ Onco 360 Pharmacy
2018.01 - 2024.03
- Streamlined prior authorization processes by implementing efficient tracking systems.
- Improved patient satisfaction with timely and accurate processing of prior authorizations for medications and procedures.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Enhanced communication between healthcare providers and insurance companies, ensuring prompt resolution of issues related to prior authorizations.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Provided training to new staff members on the intricacies of various insurance plans and their specific prior authorization requirements.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Supported team members by providing guidance on complex cases requiring detailed understanding of medical necessity criteria.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Researched denied claims and contacted insurance companies to resolve these issues.
Front Office Specialist
Drs. Vance, Stovall & Buchanan
2012.01 - 2017.12
- Enhanced customer satisfaction by efficiently managing front office tasks and providing exceptional service.
- Streamlined appointment scheduling for improved patient experience and increased daily appointments.
- Boosted office productivity by implementing effective organizational systems and maintaining accurate records.
- Collaborated with medical staff to ensure timely communication of patient information and seamless coordination of services.
- Reduced waiting times by effectively managing patient flow and promptly addressing any concerns or issues.
- Maintained strict confidentiality by securely handling sensitive patient data in accordance with HIPAA regulations.
- Facilitated clear communication between patients, providers, and insurance companies to resolve billing discrepancies and minimize financial burdens on patients.
- Optimized resource utilization by managing inventory levels, ordering supplies, and minimizing waste within the front office environment.
- Trained new team members on front office procedures, ensuring a consistent level of service excellence across all staff members.
- Completed patient check-in processes by verifying insurance and submitting forms to nursing team.
Education
MBA - Human Resources Development
Ottawa University
Ottawa, KS05.2007
Skills
- Understanding of insurance details
- Medical terminology knowledge
- Provider Relations
- Benefit Coverage
- Insurance procedures
- Patient Scheduling
- Authorizations
- Medicare and Medicaid knowledge
- Insurance Verification
- Effective communication skills
Timeline
Prior Authorization Specialist
CareMed Specialty Pharmacy/ Onco 360 Pharmacy
2018.01 - 2024.03
Front Office Specialist
Drs. Vance, Stovall & Buchanan
2012.01 - 2017.12
MBA - Human Resources Development
Ottawa University
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