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Kristyn
Authorization Specialist
Contacto
Competencias
Demonstrated experience with Medical Billing.
Demonstrated experience with Claims Processing.
Demonstrated experience with Health Information Management.
Demonstrated experience with Clinical Data Entry.
Demonstrated experience with Epic.
Educación
Resumen
Professional profile
Experiencia
Authorization Specialist
Managed high-volume prior authorization requests while following payer policies, medical necessity criteria, and regulatory requirements.. Reviewed and maintained accurate patient, insurance, authorization, and clinical information in electronic healthcare systems.. Coordinated with providers, members, and internal teams to resolve discrepancies and support timely authorization decisions.. Monitored pending work, prioritized time-sensitive requests, and maintained detailed documentation in a high-volume remote environment.. Applied strong attention to detail and HIPAA-conscious handling of protected health information.
Health Information Management Technician
Supported Health Information Management operations through medical record review, scanning, indexing, and documentation management.. Reviewed records for completeness and accuracy and helped resolve incomplete or inconsistent documentation.. Used Epic and electronic medical record systems to organize, update, verify, and retrieve patient information.. Maintained confidentiality and followed HIPAA and organizational requirements for protected health information.. Contributed to accurate health information workflows and timely completion of assigned record-processing tasks.
Medical Billing & Claims Specialist
Processed and reviewed medical claims with emphasis on accuracy, timely submission, reimbursement integrity, and payer requirements.. Applied ICD-10 and CPT coding concepts to support accurate claim preparation and billing workflows.. Verified insurance and billing information and collaborated with payers and internal teams to resolve discrepancies and denials.. Performed detailed data entry, documentation review, and quality checks while maintaining high-volume productivity.. Generated operational reports and supported workflow improvements that strengthened data integrity and revenue-cycle accuracy.
Caregiver
Provided direct patient care in a long-term care setting while accurately documenting observations and communicating changes to nursing staff.. Supported interdisciplinary healthcare teams and maintained patient safety, confidentiality, and infection-control standards.