Lynita Elder-Davis
Denver
Summary
Detail-oriented prior authorization specialist proudly offering several years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments.
Overview
24
24
years of professional experience
Work History
Customer Service Rep II / Health Benefit Advisor
Common Spirit Mountain Region
Centennial
07.2004 - Current
- Responded promptly to customer inquiries regarding their benefits and eligibility status.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Ensured accuracy of data entered into system used for managing employee benefit records.
- Performed data entry of patient demographic, insurance, billing, and other pertinent information into the system.
- Maintained thorough knowledge of current health insurance plans in order to properly advise clients on their options.
- Processed referrals from other healthcare providers in a timely manner.
- Complied with HIPAA regulations when handling sensitive patient information.
- Coordinated with external agencies and community partners to facilitate referrals and access to services.
- Coordinated the intake process, ensuring all required documentation was collected and processed.
- Scheduled and confirmed patient appointments and consultations.
Prior Authorization Specialist
Orthopedic Rehab Products
Denver
06.2001 - 05.2004
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Maintained accurate records of all authorization activities in the database system.
Education
Associate of Science - Medical Asst
Community College of Denver
Denver, CO06-1993
Bachelor of Science - Social Services
Southern Nazarene University
Bethany, OK05-1983
Skills
- Insurance verification
- Prior authorization processing
- Data entry accuracy
- Patient scheduling
- HIPAA compliance
- Customer service
- Cross-department coordination
- Effective communication
- Attention to detail
- Problem resolution
Timeline
Customer Service Rep II / Health Benefit Advisor
Common Spirit Mountain Region
07.2004 - Current
Prior Authorization Specialist
Orthopedic Rehab Products
06.2001 - 05.2004
Associate of Science - Medical Asst
Community College of Denver
Bachelor of Science - Social Services
Southern Nazarene University
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