Stephanie Fletcher
Olyphant,PA
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 5 years of managing documentation. Considered team player with exemplary multitasking skills.
Overview
20
20
years of professional experience
Work History
SENIOR PRIOR AUTHORIZATION SPECIALIST
HCSC/CIGNA GROUP
06.2022 - 03.2025
- Responded to inquiries from healthcare providers regarding prior authorization requests through phone, portal, and fax
- Utilized knowledge of medical terminology, CPT codes, and HCPCS codes during review process.
- Managed multiple systems effectively, meeting deadlines for prior authorization requests.
- Adhere to HIPAA regulations and maintained strict confidentiality when handling sensitive patient information during the prior authorization request.
- Contributed to team goals by meeting individual productivity targets while maintaining accuracy in processing.
Process Executive Medicare Medicaid CSR
Cognizant
03.2021 - 06.2022
- Provide prompt and accurate responses to all member and provider inquiries regarding billing matters, claims issues, and prior authorizations
- Respond to escalated calls in a high-volume environment; answering questions regarding provider disputes, appeals, and grievances
- Complete coverage determinations and appeals with Prime Therapeutics Benefit Manager
- Research CPT and ICD codes for healthcare providers
- Schedule transportation, process OTC items, and work with Care Coordination
Priority Services Senior Customer Service & Sales Specialist II
Bank of America
08.2013 - 06.2017
- Provide solutions for escalated calls for banking centers, customers, and third-party vendors
- Sold balance transfers, direct deposits, and cross-sales to build profitability
- Provide recommendations and assist customers with a wide array of financial solutions
Customer Marketing Operations
Bank of America
09.2010 - 08.2013
- Manage inbound calls, service client's requests, offer solutions, and deepen relationships
- Comply with all financial policies and procedures for company
- Reviewed and adjusted billing statement for clients
Senior Loan Officer / Originator
United Financial Management Group
01.2005 - 03.2007
- Originated mortgages for conventional, subprime, and FHA home purchases, refinances, and new home construction
- Reviewed credit reports, income documentation, combined asset worth, and appraisals
- Prepared loan transaction packages for preliminary approval or denial in accordance with lender guidelines
- Presented all related deal points to Loan Committee when required
Education
Bachelor of Science - Business
The Pennsylvania State University
Scranton, PA12.2004
Skills
- FACETS
- MEDHOK
- QXNT
- Cisco System
- VPN
- RxClaims
- TACS
- CLMS
- Encompass
- Calyx Point
- Microsoft Systems
Timeline
SENIOR PRIOR AUTHORIZATION SPECIALIST
HCSC/CIGNA GROUP
06.2022 - 03.2025
Process Executive Medicare Medicaid CSR
Cognizant
03.2021 - 06.2022
Priority Services Senior Customer Service & Sales Specialist II
Bank of America
08.2013 - 06.2017
Customer Marketing Operations
Bank of America
09.2010 - 08.2013
Senior Loan Officer / Originator
United Financial Management Group
01.2005 - 03.2007
Bachelor of Science - Business
The Pennsylvania State University
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