Gail Whitehead Email & Phone Number

Chapel Hill, Nc

*Processes admission notifications and/or authorization requests.*Receives and responds to authorization requests from hospitals, physicians, vendors, facilities and members based on timeliness standards. Determine authorization requirements and member eligibility for requested services. *Works as part of a multidisciplinary Health Care Coordination Team; identifies and tasks appropriate health care service delivery for selected patients, providers, procedures, and/or… Show more *Processes admission notifications and/or authorization requests.*Receives and responds to authorization requests from hospitals, physicians, vendors, facilities and members based on timeliness standards. Determine authorization requirements and member eligibility for requested services. *Works as part of a multidisciplinary Health Care Coordination Team; identifies and tasks appropriate health care service delivery for selected patients, providers, procedures, and/or diagnoses.*Identifies providers who are not following current guidelines and educates them regarding authorization requirements and procedures.*Communicates and works with clinical staff to ensure proper entry and delivery of information and authorization requests related to administrative approvals and medical necessity reviews.*Batches documents and records for imaging as required.*Determine if requests are auto approved based on ICD-9 codes and Current Procedural Terminology.BCBS of North Carolina (09/2008 – 10/2009) Durham, NCCustomer Service Professional*Answer customer inquiries with a professional attitude and manner while adhering to measurable departmental goals.*Effectively utilize and navigate using internal resources to arrive at the right solution for the client e.g. computer systems, online resources, and business partner relationships.*Demonstrating excellent call handling skills, patience and respect with complex and non-complex calls while processing transactions accurately. Show less

Raleigh-Durham, North Carolina Area

*Performs any of following duties to inspect, measure, and test semiconductor wafers for conformance to specifications.*Records inspection data on production records or in computer, using computer terminal..

Raleigh-Durham, North Carolina Area

*Responsible for all activities involving quality assurance and compliance with applicable regulatory requirements.*Reviews and monitors incoming telephone inquiries regarding products and services. Ensures teams or groups are performing and meeting the customer’s needs in a timely manner.

Raleigh-Durham, North Carolina Area

*Answer incoming calls in a call center environment.*Explain and resolve billing issues in icoms.*Investigate issues reported by customers and companies in a timely and efficient manner.*Document problem solutions and contribute to company knowledge base.*Introduce and sale products to potential customers.

Rocky Mount, North Carolina Area

*17+ years of experience in assembly line operations, machinery assembly, basic equipment repairs and quality control.*Set up and operated aseptic and terminal sterilization production lines.*Served as a blow mold operator: filling, packing and moving finished product ready for sterilization.*Several years of hand packing product to be placed on pallets and moved with pallet jack from line to autoclaves.*Filled in as a back-up line coordinator.*Created, maintained , and… Show more *17+ years of experience in assembly line operations, machinery assembly, basic equipment repairs and quality control.*Set up and operated aseptic and terminal sterilization production lines.*Served as a blow mold operator: filling, packing and moving finished product ready for sterilization.*Several years of hand packing product to be placed on pallets and moved with pallet jack from line to autoclaves.*Filled in as a back-up line coordinator.*Created, maintained , and completed CAPA’s and deviations for the department.*Created and maintained spreadsheets and charts for monthly comparisons.*Conducted daily audit of batch records, 15-25 per day, for submission to MQA.*Records inspection data on production records or in computer, using computer terminal. Show less

Bachelor'S Degree, Criminal Justice -Juvenile Concentration, Senior

Activities and Societies: Gamma Chi Tau Sigma National Honor Society

Certificate, Medical Insurance Coding Specialist/Coder

Diploma, Private Investigator