Summary
Overview
Work History
Education
Skills
Continuing Education
Timeline
Generic

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, PA
06-2005

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

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Heather Pletz