Audra Majors
Fredericksburg
Summary
Dedicated professional with extensive experience in prior authorizations and surgical coordination. Strong ability to monitor authorization statuses and collaborate with healthcare providers, ensuring efficient patient care and satisfaction.
Overview
22
22
years of professional experience
Work History
Prior Authorization Specialist
Mary Washington Orthopedics
Fredericksburg, VA
03.2022 - Current
- Processed prior authorization requests efficiently to ensure timely patient care.
- Communicated with healthcare providers to gather necessary documentation for approvals.
- Monitored authorization statuses and followed up on pending requests diligently.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
Surgical Coordinator
Raleigh Orthopedic Clinic
Raleigh, NC
09.2020 - 02.2022
- Managed surgical scheduling, optimizing patient flow and resource allocation.
- Developed and maintained relationships with insurance representatives to streamline authorization processes.
- Implemented process improvements, enhancing clinic efficiency and reducing patient wait times.
- Maintained strict adherence to HIPAA regulations, protecting the privacy of patient information at all times.
- Verified insurance coverage and obtained pre-authorization.
- Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
Surgical Coordinator
Raleigh Hand to Shoulder Center
Raleigh, NC
12.2019 - 09.2020
- Maintained strict adherence to HIPAA regulations, protecting the privacy of patient information at all times.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Coordinated pre-operative assessments with surgical teams and patients for seamless procedures.
- Arranged pre-operative and post-operative appointments for surgical patients.
- Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
- Obtained payments from patients and scanned identification and insurance cards.
Patient Coordinator
Avancecare Clayton
Clayton, NC
08.2019 - 11.2019
- Coordinated patient scheduling, optimizing appointment flows and reducing wait times.
- Managed patient intake processes, ensuring accurate data collection and compliance with regulations.
- Maintained up-to-date knowledge on insurance policies, medical terminology, and clinic protocols in order to provide accurate information and assistance to patients.
- Managed incoming calls from patients, directing them appropriately while maintaining confidentiality at all times.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Coordinated referrals to specialists as needed, following up with patients to confirm appointments and provide necessary information.
Referral Specialist
Fredericksburg Orthopaedic Associates
Fredericksburg, VA
12.2003 - 02.2017
- Coordinated patient referrals to ensure timely access to specialized care
- Managed electronic health records to maintain accurate patient information
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Assisted patients in navigating insurance requirements, facilitating approval of necessary treatments.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
Education
High School Diploma -
Stafford Senior High School
Fredericksburg06-1999
Skills
- Front Desk Operations
- Medical Records Management
- EMR Systems
- Referral Verification
- Insurance Verification
- Medical Terminology
- ICD-9
- ICD-10
- CPT Coding
- Authorizations
- Medical Appeals Handling
- HIPAA compliance
Languages
English
Timeline
Prior Authorization Specialist
Mary Washington Orthopedics
03.2022 - Current
Surgical Coordinator
Raleigh Orthopedic Clinic
09.2020 - 02.2022
Surgical Coordinator
Raleigh Hand to Shoulder Center
12.2019 - 09.2020
Patient Coordinator
Avancecare Clayton
08.2019 - 11.2019
Referral Specialist
Fredericksburg Orthopaedic Associates
12.2003 - 02.2017
High School Diploma -
Stafford Senior High School