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Kristyn
Authorization Specialist
Contacto
Competencias
Demonstrated experience with ICD-10.
Demonstrated experience with CPT Coding.
Demonstrated experience with Epic.
Demonstrated experience with EMR Systems.
Educación
Resumen
Professional profile
Experiencia
Authorization Specialist
Managed high-volume prior authorization requests, applying payer policies, medical necessity criteria, and regulatory guidelines to support accurate and timely decisions.. Maintained precise patient, insurance, clinical, and authorization data within electronic healthcare systems, ensuring data integrity across the revenue cycle.. Collaborated with providers, members, and internal teams to resolve discrepancies, clarify clinical documentation, and accelerate authorization turnaround.. Prioritized time-sensitive cases, monitored pending queues, and produced clear documentation in a fast-paced remote environment while consistently meeting productivity standards.. Uphold strict HIPAA standards and organizational confidentiality protocols when handling protected health information.
Health Information Management Technician
Supported core HIM operations including medical record review, scanning, indexing, and documentation completeness to maintain accurate patient health information.. Identified and resolved incomplete or inconsistent documentation, contributing to higher data quality and smoother clinical and billing workflows.. Leveraged Epic and enterprise EMR systems to organize, update, verify, and retrieve patient records with a high degree of accuracy and speed.. Ensured full compliance with HIPAA and organizational privacy standards while handling sensitive protected health information.. Delivered consistent, timely completion of assigned record-processing workloads in a high-acuity healthcare environment.
Medical Billing & Claims Specialist
Processed and reviewed high volumes of medical claims with a focus on accuracy, timely submission, reimbursement integrity, and strict adherence to payer requirements.. Applied ICD-10 and CPT coding knowledge to support correct claim preparation, reduce denials, and strengthen billing outcomes.. Verified insurance eligibility and billing details; partnered with payers and internal teams to investigate and resolve discrepancies, underpayments, and denials.. Performed detailed data entry, documentation review, and quality audits while consistently meeting or exceeding productivity benchmarks.. Generated operational reports and recommended process improvements that enhanced data integrity and overall revenue-cycle performance.
Caregiver
Delivered direct patient care in a long-term care setting while accurately documenting clinical observations and communicating changes to nursing leadership.. Supported interdisciplinary care teams and upheld patient safety, confidentiality, and infection-control standards.