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COMPLEX AUTHORIZATION SPECIALIST | MAY 2016-PRESENT* Reviewed and entered complex authorizations and referrals from VA and providers.* Effectively communicated medical information, test results, diagnoses and or proposed treatment in a manner easily understood by the patient. *Effectively communicated with clinical staff. *Ensured accurate data entry and completion of authorization data from customer information, medical records, referral/authorization forms, assists Patient Service Representatives (PSRs) in obtaining consult reports within required turnaround times. *Under the direction of a supervisor, requested appropriate records and process initial review of those records. Works in a fast-paced production environment.* Complied with HIPAA regulations to protect privacy of Veteran’s health information.* Documented all communications involving Veteran and provider contacts.* Worked with standard coding systems including: standard medical taxonomy, International Classification for Diseases, Current Procedural Terminology, and Health Care Common Procedure Coding System.* Verified and ensured that appropriate referral procedures are followed for the various types of VA eligible beneficiaries. * Identified potential discrepancies in the medical management system to assure quality compliance.*Managed large amounts of complex information easily, communicate clearly, and draw sound conclusions. *Point of contact for VAMC and peers *Maintained ongoing training and resources to adequately perform duties for this role.*Trained New hires during Nesting Phase

* Offering versatile office management skills and proficiency in Microsoft Office programs. * Strong planner and problem solver who readily adapts to change, works independently and exceeds expectations. * Provides exceptional customer service to several Clients as an IBO. * Able to juggle multiple priorities and meet tight deadlines without compromising quality.

Serviced existing accounts, obtained orders, and established new accounts by planning and organizing daily work schedule to call on existing or potential sales outlets. Focused sales efforts by studying existing and potential volume of dealers. Displayed courtesy and strong interpersonal skills with all customer interactions. Resolved customer complaints by investigating problems; developing solutions; preparing reports; making recommendations to management. Maintained professional and technical knowledge by attending educational workshops. Provided historical records by maintaining records on area and customer sales. Provided thorough support and problem resolution for customers. Contributed to team effort by accomplishing related results as needed.

* Resolved product issues and shared benefits of new technology. * Managed quality communication, customer support and product representation for each client.* Displayed courtesy and strong interpersonal skills with all customer interactions.* Informed customers about issue resolution progress. * Supported customers having data connectivity issues. * Provided thorough support and problem resolution for customers.

MEDICAL RECEPTIONIST/MEDICAL RECORDS CLERK • Promptly greets and acknowledges patients. Informs MAs and Providers of patient’s arrival.• Instructs patients in completion of medical history and patient information forms, and makes any necessary corrections to the patients account. Obtains accurate, complete demographic and insurance information and financial contract / consent on patient paperwork as well as interviewing patients and guarantors to obtain accurate information.• Responsible for identifying and collecting co-payments, co-insurances and past due account balances.• Explains financial requirements to the patient in response to patient questions on billing and insurance matters; refers questions regarding more complex insurance/benefits questions to Site Billing Specialist.• Responsible for accurately completing and interpreting insurance verification and benefits. Notifies patients, family members, physicians and/or supervisors of network insurance coverage issues that may result in coverage reduction.• Screens upcoming appointments for required referrals and/or authorizations.• Scans all new patient or updated patient information into computer (including: photo ID, insurance cards, referrals, and patient paperwork).• Schedule follow up appointments, reviews with patient their estimate out of pocket responsibility for future appointments, review patient’s insurance coverage and notify patient if service requires an authorization or referral.

Operated multi-line phone operating system. Answer, transfer and direct incoming calls using a computerized database for information access Directed and screened calls to and for over 200 employees. Emailed escalated calls to Supervisors. Monitored Dispatch for Base in lieu of Social workers. Handled data entry and file clearing of cases. Front Desk Reception. Give routine, non-interpretative information on request and keep updated on daily activities of caseworkers to respond to and provide callers with current application information. Perform inputting, updating, maintenance and accuracy checks on a computerized database.

Handle multifaceted clerical tasks (e.g., data entry, filing, and records management) in addition to direct sales as the General Manager. Recruited and trained many Team Members, maintained database and ensured the delivery of premium service to all clients. Exceeded sales quotas.

Handled multifaceted clerical tasks in addition to sales as the Account Executive. Quickly became a trusted assistant known for “can-do” attitude, flexibility and high-quality work. Exceeded sales quotas and achieved Manager position in less than three months. Helped coordinate recruitment events that contributed to consistently high employment levels.

Offered comprehensive background investigations for all nuclear plants worldwide regarding applicants. Administered background information check, including employment history as well as personal references, educational history, and credit checks for all applicants seeking unescorted access to the nuclear power plants worldwide.

— Offered traffic measurement and analysis of timing, tracking, and efficiency on the exhibition floor. Managed the analysis of video, registration and lead retrieval data, develop client and sales reports based on created spreadsheets and develop management reports based on those forms, exceeded productivity goals. Developed innovative PowerPoint presentation used by outside companies to market executive support programs to potential clients. Trained new employees. Entrusted to manage office in the supervisor’s absence.

* Offered technical and sales information to dealers and customers. * Developed client databases and documented sales. * Managed product exchanges and scheduling. * Handled multifaceted clerical tasks (e.g., data entry, filing, and records management). * Communicated effectively with multiple departments.* Established strong relationships to gain support and effectively achieve results. * Earned excellent marks on performance reviews, with citations for excellence in areas including work volume, accuracy and quality; ability to learn and master new concepts; positive work ethic; and commitment to providing unsurpassed service.* Provided timely, courteous and knowledgeable response to information requests; screened and transferred calls; and prepared official correspondence.