Debra Dancer Shaw Email & Phone Number

Charleston, South Carolina

Opened and built cases for prior authorization requests; verified patients were in network. Coordinated and forwarded PA cases to nurses; advised hospitals, clinics, doctor’s offices on the status of open PA requests. Coordinated requests with utilization nurses. Notified providers of approved or denied authorizations. Obtained missing information or documentation from providers.

Charleston, Sc

Responsible for obtaining provider documentation required by SCHHS and Medicaid. Tracked receipt of documents and new Medicaid ID numbers, coordinated efforts with Account Executives, reported status to management. Assisted with processing applications for providers serving Medicaid and Dual Demonstration patients.

Irving, Tx

Prioritized and processed Prior Authorizations for PBM members; assisted doctors’ staffs to obtain exceptions for non-covered prescriptions. Provided enrollment information and coverage comparisons for Medicare Part D plans.Assisted pharmacy tech department by researching and routing queues for medication refills.

Westlake, Tx

Held Series 6 & 63 licenses; was a registered representative for workplace retirement plans.Educated customers on plan benefits and relevant IRS regulations; researched customer account issues. Processed enrollments and investment transactions for 401K, 403B, 457 & Deferred Compensation plans. Promoted to positions on Master Team, Executive Services, and Priority Services.

Coppell, Tx

Researched, analyzed, and advised appropriate action on mortgages falling into foreclosure. Revised delinquent mortgage files. Built and logged mortgage files for manager's reports.

Bachelor Of Science, Education

Post-Graduate Studies In Marketing And Business

Master'S Level Studies In English As A Second Language