Kiana Taylor
Shakopee
Summary
Benefits Investigation Specialist recognized for exceptional productivity and efficient task execution. Expertise in benefits verification, insurance authorization, and regulatory compliance ensures accuracy and timeliness in operations. Strong communication and problem-solving skills facilitate navigation of complex healthcare systems, delivering optimal results for providers and patients.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Benefits Investigation Specialist
Sterling Specialty Pharmacy
Mendota Heights
06.2023 - Current
- Engaged daily with diverse cultural backgrounds, ensuring respectful and patient interactions.
- Maintained precise records of authorization activities within database system.
- Initiated prior authorizations for various medications.
- Managed multiple programs concurrently to enhance operational efficiency.
- Verified patient insurance coverage, including eligibility, benefits, and medical service authorizations.
- Responded promptly to inquiries from providers, patients, and payers regarding prior authorization statuses.
- Contacted insurance companies for eligibility verification and benefit confirmation.
- Coordinated resolutions for issues and appealed denied authorizations, identifying root causes.
Delivery Driver
Caffrey's Deli & Subs
Minneapolis
08.2017 - 06.2023
- Adhered to traffic laws and transportation procedures during all deliveries.
- Ensured accurate completion of delivery paperwork.
- Regularly communicated with dispatch regarding route delays and issues.
- Prepared food orders efficiently to meet customer demands.
- Restocked supplies to maintain operational readiness.
- Maintained cleanliness of work area to ensure compliance with health standards.
- Operated cash register accurately, processing transactions swiftly.
- Tracked order receipts meticulously for inventory management.
Registered Pharmacy Technician Prior Authorization
Alorica
Mendota Heights
04.2014 - 08.2016
- Processed prior authorizations for Medicaid and Medicare recipients via phone and fax.
Approved or denied medication coverage based on insurance guidelines.
Communicated with healthcare providers and patients to resolve authorization issues.
Utilized dual monitors to efficiently manage multiple systems simultaneously. - Provided customer service support by responding promptly and professionally to inquiries from patients, physicians' offices, insurance companies. via phone or email.
- Prepared and processed medical insurance claim forms and records.
- Teamed with peers, technicians and pharmacists to prioritize and complete orders.
- Researched drug formularies as well as therapeutic alternatives when needed during the authorization process.
- Answered telephones to respond to questions or requests.
- Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
- Verified insurance benefits to refill medications by examining formularies and calling insurance companies for exceptions.
Education
Some College (No Degree) -
MCTC
Minneapolis, MNSkills
- Prior authorization and insurance verification
- Claims processing and benefits administration
- Patient advocacy and customer service
- Database management and operational efficiency
- Medical terminology and HIPAA compliance
- Effective communication and active listening
- Cultural competency and conflict resolution
- Attention to detail and detail orientation
- Strong analytical skills and critical thinking
- Reliability in healthcare settings
Certification
- Pharmacy Technition Registration
Timeline
Benefits Investigation Specialist
Sterling Specialty Pharmacy
06.2023 - Current
Delivery Driver
Caffrey's Deli & Subs
08.2017 - 06.2023
Registered Pharmacy Technician Prior Authorization
Alorica
04.2014 - 08.2016
Some College (No Degree) -
MCTC
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