- Proficient in obtaining prior authorizations for medical procedures, tests, medications, and durable medical equipment (DME) from insurance companies, ensuring timely approvals and minimizing delays in patient care.- Thoroughly verify patients’ insurance coverage, including eligibility, benefits, and coverage limitations, to facilitate accurate billing and claims processing.- Analyze medical records and documentations to assess the medical necessity of requested services, applying knowledge of coding terminology and medical guidelines to ensure accurate prior authorization submissions.- Collaborate with healthcare providers to obtain additional documentation or clinical justification s needed to support authorization requests.- Identify opportunities for process involvement and efficiency enhancement within the prior authorization, billing, and claims processing workflows, implementing solutions to mitigate errors and optimize revenue cycle management.

- Maintained a 99% accuracy rate in reviewing and updating patient medical records, ensuring compliance with HIPAA regulations and organizational standards for data security and confidentiality.- Demonstrated outstanding customer service skills in assisting patients with insurance inquiries, clarifying coverage details, and addressing concerns promptly and courteously, resulting in a 95% satisfaction rate.- Educated patients on their insurance coverage, benefits, copayments, deductibles, and out-of-pocket expenses, providing clear and accurate information to support informed decision-making and financial planning.- Ensured accurate and updated patient demographics and insurance information in electronic health records (EHR) systems, ensuring the accuracy and completeness of patient records for billing and claims processing.- Proactively addressed claim denials, rejections, and discrepancies, conducting thorough research and follow-up to resolve issues and optimize reimbursement.

O Greeted customers in a friendly and timely fashion while quickly and effectively addressing their needs and concerns.O Recommended products to customers based on their needs and preferences.O Maintained knowledge of products, current sales, goals, and promotions.O Built client relationships with customers to result in a personable, genuine, and engaging service.O Routine make-up applications, skin care applications, and recommendations. O Contributed to team success by exceeding team sales goals as well as personalgoals.O Participated in weekly and monthly training seminars to maximize sales, customer satisfaction, repeat business, and brand reputation.O Responsible for training of makeup application techniques, skincare regimens, product knowledge, and selling tactics to Beauty Advisors.O Maintained customer relationships by contacting for events or inviting them in store to provide personable experiences that resulted in sales and repeat business.O Planned, executed, and participated in high volume events.O Generated a positive work atmosphere through positive leadership, clearcommunication, and encouragement.