Heather Pletz
Allentown
Summary
Dynamic Authorization Specialist with extensive experience at LVHN, excelling in insurance verification and workflow optimization. Proven track record in securing timely pre-authorizations and enhancing patient communication. Skilled in electronic health records and employee training, fostering a collaborative environment to ensure compliance and exceptional service delivery.
Overview
7
7
years of professional experience
Work History
Authorization Specialist
LVHN
Allentown
10.2024 - Current
- Reviewed and processed patient authorization requests for medical services.
- Communicated with healthcare providers to verify insurance coverage details.
- Utilized electronic health record systems to manage patient information efficiently.
- Monitored and tracked authorization timelines to meet departmental standards.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Reviewed authorization requests for accuracy and completeness.
- Monitored daily workflow queues within the department ensuring all tasks are completed accurately and timely.
- Provided customer service to internal and external customers related to authorization requests.
- Processed prior authorization requests in accordance with departmental guidelines.
- Conducted training sessions for new employees regarding company policies related to the authorization process.
- Participated in meetings with staff members from other departments such as billing and coding teams to provide clarification on policies related to authorizations.
Insurance Coordinator
LVHN Neurology
Allentown
08.2018 - 10.2024
- Participated in meetings with senior management to discuss current projects and develop action plans for implementation.
- Secured pre-authorizations and pre-certifications for minor surgical procedures performed in office settings.
- Assisted in the preparation of insurance documents, including applications, claims forms and renewal notices.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Reviewed and processed patient authorization requests for medical services.
- Communicated with healthcare providers to verify insurance coverage details.
- Utilized electronic health record systems to manage patient information efficiently.
- Assisted patients in understanding their insurance benefits and requirements.
- Monitored and tracked authorization timelines to meet departmental standards.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Reviewed authorization requests for accuracy and completeness.
- Monitored daily workflow queues within the department ensuring all tasks are completed accurately and timely.
- Provided customer service to internal and external customers related to authorization requests.
- Processed prior authorization requests in accordance with departmental guidelines.
Education
High School Diploma -
William Allen High School
Allentown, PA06-2005
Skills
- Insurance verification
- Electronic health records
- Prior authorizations
- Healthcare regulation compliance
- Customer relationship management
- Workflow optimization
- Employee training
- Effective communication
Continuing Education
- Currently enrolled in college furthering my education
Timeline
Authorization Specialist
LVHN
10.2024 - Current
Insurance Coordinator
LVHN Neurology
08.2018 - 10.2024
High School Diploma -
William Allen High School