• Leading and managing the Diabetes Device Prior Authorization team for Edgepark Medical Supplies.• Indirectly leading, training, and communicating with offshore partners.• Overseeing production status, goal setting, game-planning, escalations, process improvements, training opportunities, and quality standards.• Monitoring individual and team performance through productivity and quality metrics.• Addressing performance concerns through direct, consistent communication as well as personalized improvement plans, training, and support.• Identifying opportunities to improve and align, creating standard operating procedures to support those enhancements, conducting any necessary training, and following through with implementation.• Collaborating with other teams and leaders across the business on various initiatives to increase customer satisfaction and operational effectiveness.• Utilized change management to successfully navigate my team through multiple organizational and functionaltransformations.• Member of the winning team for an executive leadership initiative to solve major organizational pain points.• Grew the team from 13 agents to upwards of 25 agents in a period of 6 months.• Decreased order cycle times for both authorization submissions and follow ups by over 50%.• Implemented and sustained a Proactive Authorization process for 5 high-volume payers.• A3 process and Leader Standard Work experience.

• Audited customer orders for insurance verification, eligibility, medical policy, prior authorization, claim reimbursement and outstanding balances• Assisted the Prior Authorization supervisor with game-planning, managing daily workloads, and facilitating team huddles• Supported the Prior Authorization team through training and coaching in standard policies, procedures, and best practices• Developed and implemented several internal SOPs

• Inside sales representative for diabetic devices including insulin pumps, continuous glucose monitoring devices and related supplies• Cross-sold patients into diabetic devices, promoted additional ancillary supplies and communicated order details to finalize the sale• Connected with insurances, doctor’s offices, and medical professionals to gather and confirm necessary information as well as obtain authorization approvals• Managed inbound customer service calls relating to placing and confirming orders, checking order status, and answering questions about the diabetic supplies Edgepark offers

• Assisted the Biller supervisor with game-planning, training, and quality-auditing• Led monthly kick-off meetings with the billers to address recurring issues and communicate pertinent updates• Tracked daily production and performance goals for the Medical Device Billing team• Monitored the supervisor phone queue and resolved customer complaints and order-related issues

• Audited customer orders for benefit verification, medical documentation, authorization, and reimbursement in a fast-paced work environment while hitting challenging production goals• Stayed up to date on funding guidelines for Medicare, Medicaid and private insurances, EOB/procedure codes, ICD9 and ICD10 codes, HCFA 1500 claim submission, and HIPAA compliance

• Obtained authorizations and referrals from insurance companies, medical groups, and doctors for high-dollar inventory including diabetic, anticoagulation, enteral and pleural effusion supplies• Managed high volumes of outbound and inbound calls from customers and health care providers

• Verified primary and secondary insurance coverage and benefits for customers through outbound calls and insurance web portals

• Assisted residents suffering from memory loss with Activities of Daily Living as well as engaged them in daily physical and cognitive exercises

• Aided adults with developmental disabilities in a group home setting with Activities of Daily Living and encouraged their participation in community outings and events