Allison Hebb
Gladehill
Summary
Dedicated Prior Authorization Specialist ,with over 8 years of experience with processing prior authorizations and 17 years in pharmacy experience, known for analyzing complex cases and maintaining accurate documentation. Leverages effective communication and professionalism to resolve authorization issues and support timely patient care.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Carilion
Roanoke, VA
04.2018 - 05.2026
- Processed more than 20 prior authorization requests efficiently, ensuring compliance with healthcare regulations.
- Collaborated with healthcare providers to resolve authorization issues and expedite patient care.
- Analyzed complex case details to determine eligibility for services and procedures.
- Trained junior staff on system navigation and best practices for prior authorization processes.
- Maintained accurate documentation of appeals and denials to support quality assurance efforts.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Pharmacy Technician
Kroger Pharmacy
Rocky Mount, VA
10.2013 - 04.2018
- Managed prescription processing and ensured accuracy in medication dispensing.
- Provided exceptional customer service by addressing inquiries and resolving issues promptly.
- Collaborated with pharmacists to maintain inventory levels and manage stock replenishment.
- Trained and mentored new pharmacy technicians on operational procedures and best practices.
- Verified prescription accuracy and ensured compliance with state and federal regulations.
- Assisted pharmacists in preparing and dispensing over 300 prescription medications while maintaining safety protocols.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Increased customer satisfaction by delivering friendly, personalized service during transactions.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Collected co-payments or full payments from customers.
- Resolved non-routine issues like third-party billing, computer system, and customer service issues.
Admixture Pharmacy Technician
Carilion Roanoke Memorial Hospital
Roanoke, VA
10.2012 - 10.2016
- Managed medication inventory, ensuring accurate stock levels and timely replenishment.
- Compounded medications according to prescription orders, adhering to safety standards and protocols.
- Trained new pharmacy technicians on operational procedures and departmental policies.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
- Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
- Assisted in maintaining a clean and organized work environment, ensuring compliance with safety regulations.
- Counted, measured, and compounded medications following standard procedures.
- Maintained proper drug storage procedures, registries, and records for controlled drugs.
- Optimized workflow efficiency through participation in regular team meetings discussing areas for improvement within the department.
- Aided pharmacists in preparing over 100 sterile compounding products for IV administration using aseptic techniques.
- Maintained clean and organized work environment, adhering to health and safety standards.
Certified Pharmacy Technician
CVS Pharmacy
Rocky Mount, VA
08.2009 - 10.2012
- Managed inventory control, including ordering and stocking pharmaceutical supplies efficiently.
- Trained new pharmacy technicians on standard operating procedures and best practices.
- Implemented process improvements that enhanced workflow efficiency within the pharmacy department.
- Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
- Worked with computerized and automated systems for dispensing over 500 medications and editing new patient profiles.
- Communicated with prescribers to verify medication dosages, refill authorizations, and patient information.
- Reviewed and verified customer information and insurance provider information.
- Managed insurance billing and claims processing, streamlining the reimbursement process for patients and pharmacy.
- Proactively addressed potential conflicts or discrepancies within the pharmacy team to maintain a positive work environment.
Education
No Degree - General Studies
Virginia Western Community College
Roanoke, VA05.2012
High School Diploma -
Franklin County High Schoo
Rocky Mount, VA06.2008
Skills
- Prior authorization process
- Benefit coverage
- Professionalism and ethics
- Proficiency in Microsoft
- ICD-10 coding
- Eligibility determination
- Medical appeals handling
- Insurance verification
- Effective communication skills
- Data entry
- Electronic health records proficiency
- Medical terminology knowledge
Certification
- Pharmacy Technician - Pharmacy Technician Certification Board- 500107010061131- Acquired- 11/2009 -Expires- 11/30/2027
- Pharmacy Technician - Commonwealth of Virginia- 0230014321- Acquired- 03/2009- Expires- 12/31/2026
Timeline
Prior Authorization Specialist
Carilion
04.2018 - 05.2026
Pharmacy Technician
Kroger Pharmacy
10.2013 - 04.2018
Admixture Pharmacy Technician
Carilion Roanoke Memorial Hospital
10.2012 - 10.2016
Certified Pharmacy Technician
CVS Pharmacy
08.2009 - 10.2012
No Degree - General Studies
Virginia Western Community College
High School Diploma -
Franklin County High Schoo