QuickBooks
Malissa Wammack
Pre-Authorization Coordinator
Batesville,AR
Summary
Knowledgeable insurance professional with comprehensive background in facilitating authorization processes and ensuring compliance with industry regulations. Proven track record in collaborating with cross-functional teams to streamline workflows and enhance operational efficiency. Demonstrated ability in problem-solving and maintaining meticulous records.
Overview
14
14
years of professional experience
5
5
years of post-secondary education
1
1
Certification
Work History
Pre-Authorization Coordinator
St Bernard's Heart And Vascular
Batesville, AR
08.2021 - Current
- Calculated estimated copay based on current insurance benefits.
- Contributed to the development of departmental policies and procedures relating to authorization management, promoting standardization across teams.
- Increased efficiency in handling authorization cases through effective prioritization based on urgency and complexity levels.
- Stayed informed about regulatory changes relevant to the healthcare industry, ensuring compliance in all authorization activities.
- Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
- Reduced errors in documentation submissions by performing meticulous quality checks before forwarding them to insurance companies.
- Reviewed authorizations from payer to determine approved or denied items.
- Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
- Streamlined authorization processes by implementing a centralized tracking system for pending and approved requests.
- Maintained up-to-date knowledge of insurance policies, enabling accurate evaluation of coverage eligibility criteria for patients.
- Acted as a resource for clinical staff, providing guidance on insurance requirements and authorization protocols.
Regional Insurance Advisor
ARcare
Augusta, AR
08.2017 - 02.2020
- Coordinated and provided care that is safe, timely, effective, efficient, equitable and client-centered
- Developed marketing strategies to promote new insurance contracts or suggest additions and changes to existing policies.
- Used health information systems efficiently to manage and improve services at individual and system levels and ensured delivery of timely and accurate information
- Assured program records conform to area Mental Health standards/Health Department standards and meet CMS Medicare/Medicaid requirements Facilitated multiple care aspects (case coordination, information sharing, etc.)
- Assisted patients to make informed decisions by acting as their advocate regarding their clinical status and treatment options
- Recorded case information completed accurately all necessary forms and produced statistical reports
- Coached, mentored, and developed staff, including overseeing new employee onboarding and providing career development planning and opportunities for 12 clinics
- Maintained employee work schedules including assignments, job rotation, training, vacations and paid time off, telecommuting, cover for absenteeism, and overtime scheduling
- Lead employees using performance management and development process that provides overall context and framework to encourage employee contribution and includes goal setting, feedback, and performance development planning
- Calculated quotes and educated potential clients on insurance options.
- Maintained high standards of customer service by building relationships with clients.
- Displayed consistent, positive attitude towards customers, peers and other personnel, even during high-stress situations.
- Performed administrative tasks, including policy renewal and record retention.
Voluntary Benefits Worksite Administrator
Security Benefits Solutions
Batesville, AR
08.2011 - 04.2017
- Briefed new hires on essential job information, such as company policies, employment benefits and job duties.
- Negotiated contracts, implemented policies, and filed/processed claims for multiple clients and insurance companies
- Trained and lead clients through benefits analyses and other strategic planning processes
- Established new and streamlined existing office systems using Microsoft Office programs
- Created print media using Adobe Suite programs while maintaining integrity and accuracy of marketing material per vendor specifications
- Coordinated activities of human resources team, distributing resources and personnel effectively across organization to meet HR needs.
- Streamlined HR efficiencies, coordinated new hire orientations and provided onboarding and training for 15-25 new employees.
Education
Associate of Applied Science - Accounting and Business/Management
University of Arkansas Community College-Batesville
Batesville, AR 08.2002 - 12.2004
Associate of Applied Science - Early Childhood Education And Teaching
University of Arkansas Community College-Batesville
Batesville, AR 08.2002 - 12.2004
Skills
Computer skills
Customer Service
Cultural awareness
Conflict resolution
Self-motivated professional
Verbal and written communication
Analytical skills
ICD-10 Coding
Medicare and Medicaid knowledge
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Supervised team of 8 staff members.
- Documented and resolved claims processing and denials which led to 97% timely payments.
Software
Microsoft Office
Adobe Suite
Electronic Medical Records
Certification
Dale Carnegie - The Leadership Advantage 2018
Timeline
Pre-Authorization Coordinator
St Bernard's Heart And Vascular
08.2021 - Current
Dale Carnegie - The Leadership Advantage 2018
03-2018
Regional Insurance Advisor
ARcare
08.2017 - 02.2020
Voluntary Benefits Worksite Administrator
Security Benefits Solutions
08.2011 - 04.2017
Associate of Applied Science - Accounting and Business/Management
University of Arkansas Community College-Batesville
08.2002 - 12.2004
Associate of Applied Science - Early Childhood Education And Teaching
University of Arkansas Community College-Batesville
08.2002 - 12.2004
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