Process notification requirements for outpatient procedures, home health, DME, and network GAP issues. Interpret and apply state and federal mandates and regulations to review and administratively approve preauthorization request. Prepare benefit language to support approval or denial of preauthorization request. Communicate decision outcomes to providers and members.

As a Clinical Administrative Coordinator at United Health Group, I leverage my expertise in healthcare administration and information technology to ensure the efficient management of clinical processes and support services. My responsibilities encompass a range of administrative tasks crucial to patient care and provider services, including:Prior Authorization Management: Handling cases related to prior authorization, ensuring timely administrative approvals, & preparing cases for review by registered nurses and medical directors in compliance with Department of Labor (DOL) time frames.Documentation & Data Entry: Maintaining accurate and detailed records, documenting all interactions and processes with meticulous attention to detail, and ensuring data integrity within the healthcare system.Provider & Patient Interaction: Answering calls from healthcare providers, entering service requests, and delivering excellent customer service to both providers and patients. My role involves addressing inquiries, resolving issues, and facilitating smooth communication.Regulatory Compliance: Ensuring all processes comply with regulatory standards, including appropriate use of ICD-10 & CPT coding for medical services and procedures.Workflow Management: Planning, prioritizing, and organizing work to meet established objectives and turnaround times, thereby contributing to the overall efficiency and effectiveness of the clinical administrative team.Quality Assurance: Demonstrating a strong attention to detail to ensure high standards of quality in all administrative functions and meeting weekly metrics to maintain operational excellence.This role has honed my skills in healthcare administration, customer service, and data management, while providing me with valuable experience in navigating the complexities of the healthcare industry. I am dedicated to supporting the delivery of high-quality patient care through precise administrative coordination and robust support services.

Assisted individuals with intellectual disabilities living at the Selinsgrove Center with their daily needs.

Responsible for filling bottles with prescribed medications, apply labels to medication bottles, collect payments from patients and keep a record of inventory. Translate prescription orders from doctors offices.