Summary
Overview
Work History
Education
Skills
Timeline
Generic

Teia Pierce

Liberty,SC

Summary

Experienced in prior authorization within healthcare settings, handling tasks such as ensuring accuracy of patient insurance information and obtaining necessary approvals for medical procedures. Experienced with navigating complex prior authorization processes and insurance regulations. Utilizes effective communication and problem-solving skills to expedite approvals and ensure compliance. Track record of enhancing workflow efficiency and supporting team collaboration.

Overview

11
11
years of professional experience

Work History

In home caregiver

Samaritan Bed and Bath
09.2023 - Current
  • Monitored health and well-being of clients and reported significant health changes
  • Assisted with meal planning to meet nutritional plans.
  • Encouraged independence among patients through teaching them how to perform everyday tasks safely.
  • Transported clients to medical appointments, errands and recreational outings, utilizing personal vehicle

Prior Authorization Specialist

Medbridge Group
03.2020 - 09.2023
  • Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
  • Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.
  • Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
  • Coordinated resolutions for issues and appealed denied authorizations.
  • Followed up on pending prior authorization requests to ensure timely processing.
  • Advised provider offices on proper coding practices that are necessary for successful claim submission.
  • Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.

Accounts Payable and Data Entry

Ansco & Associates LLC
01.2018 - 01.2019
  • File all plats from previous worked jobs.
  • Keep up with all trucks on jobs and materials bought.
  • Call 811 to get previous markers set.
  • Answer incoming calls and provide good customer service.

Prior Authorization/Insurance Specialist

Cornerstone Family Medicine
03.2014 - 06.2017
  • Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
  • Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.
  • Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures, and follow up on all pending prior authorizations request.
  • Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
  • Helped all patients with any problems or concerns they had with medication refills, patient assistance, FMLA or Disability paperwork that needed to be filled out.
  • Keep medical records scan correctly, adding any updated info that was needed.
  • Call return all messages from patients from nurse line
  • Call reminder for next day appointments, while rescheduling if necessary.
  • Help CMAs work patients up when busy.

Education

Certificate - Medical Receptionist

Greenville Technical
Greenville, SC

Skills

  • Prior authorization process
  • Medical terminology
  • Medical appeals handling
  • Insurance verification
  • Data entry
  • Physician order verification

Timeline

In home caregiver

Samaritan Bed and Bath
09.2023 - Current

Prior Authorization Specialist

Medbridge Group
03.2020 - 09.2023

Accounts Payable and Data Entry

Ansco & Associates LLC
01.2018 - 01.2019

Prior Authorization/Insurance Specialist

Cornerstone Family Medicine
03.2014 - 06.2017

Certificate - Medical Receptionist

Greenville Technical

Similar Profiles

CREATE PROFILE
Teia Pierce