Customer Service Prior Authorization

Janet Roth

ad7vk6@r.postjobfree.com 480-***-**** Tempe, AZ

SUMMARY

Seasoned professional with 36 years of customer service experience, seeking a Housing Claims & Prior Authorization Manager role. Skilled in claims processing, EHR management, and medical technology utilization. Demonstrated proficiency in prior authorization, Medicare/Medicaid, and adherence to regulatory standards. WORK EXPERIENCE

NPIC - National Passport Information Center Phoenix AZ Inbound Customer Service Federal Contract Employee Dec 2023 - Apr 2024

• Addressed and resolved customer inquiries regarding passport regulations, contributing to adherence to Department of State policies.

• Assisted individuals with passport application and renewal processes, facilitating compliance with federal requirements.

• Improved customer experience by providing clear guidance and support for international travel documentation procedures.

United Healthcare-Optum Phoenix, AZ

Customer Service Representative/Billing and Eligibility Aug 2020 - Jan 2021

• Handled high volumes of inbound calls, verifying caller identities and safeguarding personal information with strict adherence to confidentiality protocols.

• Processed policy adjustments and updates in accordance with company policies and customer specifications, ensuring accuracy and attention to detail.

• Identified and directed intricate customer issues to specialized teams, facilitating prompt resolutions and contributing to improved customer satisfaction.

Department of Economic Security Mesa, AZ

Program Services Evaluator II, Temp Contractor Jul 2020 - Sep 2020

• Processed client applications for various assistance programs, ensuring accuracy and adherence to processing timelines.

• Maintained and managed application workflow, emphasizing data accuracy and efficient service provision.

• Delivered client-focused support, facilitating access to medical, financial, and nutritional benefits. Centene Corporation St. Louis, MO

Customer Service Representative II Sep 2017 - Jan 2022

• Addressed and resolved customer grievances in accordance with regulatory standards, upholding company benchmarks for customer satisfaction.

• Instructed customers on the details of Medicare Advantage Plans, aiding in their understanding and enabling informed healthcare choices.

• Delivered comprehensive explanations of healthcare benefits and services to customers, ensuring their clear understanding and effective utilization.

• Responsible for completing and processing prior authorization through their Medicare/Medicaid for needed new medical treatment(s) with their current primary or specialists medical providers. Walmart stores Tempe and Mesa, AZ

Lead Bakery Cake Decorator Jan 2007 - Mar 2011

• Optimized bakery operations by revising policies and implementing new procedures, resulting in improved efficiency and productivity.

• Delivered comprehensive training to new cake decorators to ensure proficiency and consistent adherence to quality standards.

• Maintained high standards of artistic and technical skill in cake decoration, contributing to customer satisfaction and repeat business.

Federal Service Positions Luke AFB Glendale, Arizona Revenue Service Tax Consultant - VITA Federal Tax Program Sep 2006 - Apr 2010

• Led a team of tax preparers to ensure adherence to IRS regulations and accurate employment form processing.

• Managed military tax data integrity and effectively utilized IRS software to identify and resolve accounting discrepancies.

America West/US Airways/American Tempe, AZ

Inbound Reservation Center Sep 1979 - Oct 2008

• Provided high-quality customer service, achieving positive feedback and satisfaction from a varied customer base.

• Cultivated and maintained strong relationships with travelers, contributing to increased repeat patronage.

• Created detailed reference materials to efficiently deliver airline information and services. EDUCATION

John H. Patterson High School

High School Graduate, N/A

Arizona State University

Attended, N/A

Tempe

Mesa Community College

Attended, N/A

Mesa

CERTIFICATIONS

Microsoft Certified Professional, Microsoft 1999

Arizona Certified Notary, State of Arizona 2023

SKILLS

Medical Patent Invention Pending • Time Management • Productivity • Operations • Written Communication • Microsoft Office Proficiency • Marketing • Customer Service Sales Force • Corporate Liaison • Organization Skills

• Cold Calling • Client Relations • Federal Government Consultant • Problem Solving • Communication • Data Retrieval • Data Input • Collaboration

CUSTOM SECTION

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