Kristen Holly Higgins
Clinton,MS
Summary
Reliable Prior Authorization Specialist with experience working in fast-paced, clinical environments. Experienced in insurance authorizations for medical oncology and other therapeutic infusion services.
Overview
10
10
years of professional experience
Work History
Prior Authorization Specialist
Baptist Memorial Health Care
07.2023 - Current
- Managed authorization requests for 3 medical oncology clinics with high volume and urgent patient needs.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Enhanced communication between healthcare providers and insurance companies, ensuring prompt resolution of issues related to prior authorizations.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
Admissions Representative
Mississippi Baptist Medical Center
07.2022 - 07.2023
- Answered over 50 telephone calls to offer office information, answer questions, and direct calls to staff.
- Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy.
- Managed multiple schedules and prioritized tasks to meet demands of fast-paced work environment.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Collaborated with healthcare staff to verify alignment of appointment scheduling with clinic protocols.
- Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
Office Coordinator
Mississippi Baptist Medical Center
11.2019 - 05.2022
- Proficient with EPIC software and able to quickly learn new systems with self-motivated approach
- Staff training
- Schedule management
- Typing 80 wpm
- Appointment scheduling
- Updated patient charts with demographic and insurance information.
- Assisted with billing by acquiring insurance authorizations for procedures and tests ordered by attending physicians.
- Maintained smooth patient flow by handling check-in, check-out, and payment procedures.
- Coordinated patient admissions through proactive communication with hospital personnel.
- Controlled office supplies, including placing new orders, monitoring usage, and coordinating regular restocking.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff
Human Resources Coordinator
RPT Distributing
07.2015 - 11.2019
- Conducted audits of payroll, benefits, and other programs, developing recommendations for corrective action to optimize systems
- Acted as point of contact for internal personnel, resolving issues and complaints effectively.
- Organized and maintained employee records for over 80 hourly and salaried staff.
- Administered healthcare plans, including enrollments, terminations, and changes.
- Managed payroll administration relevant data, including hours, absences, and bonuses.
- Coordinated and led new hire orientations and benefits meetings.
- Worked with managers to achieve compliance with organizational policies, providing clarifying information and recommending necessary changes
Receptionist
Herrin-Gear Toyota
03.2014 - 07.2015
- Communicated with personnel to route messages, coordinate internal appointments, or direct personnel to various departments.
- Managed multiple tasks and met time-sensitive deadlines
- Helped office staff prepare reports and presentations for internal or client-related use
Education
Some College (No Degree) - General Studies
Holmes Community College
Ridgeland, MSHigh School Diploma -
Northwest Rankin High School
Flowood, MS05.2010
Skills
- Reviewing Patient Information
- Data Entry
- Insurance Authorizations
- Physician order verification
- Medical Terminology
- Benefit Coverage
- Insurance procedures
- Insurance Verification
- Medical Coding
- ICD-10 Coding Familiarity
Timeline
Prior Authorization Specialist
Baptist Memorial Health Care
07.2023 - Current
Admissions Representative
Mississippi Baptist Medical Center
07.2022 - 07.2023
Office Coordinator
Mississippi Baptist Medical Center
11.2019 - 05.2022
Human Resources Coordinator
RPT Distributing
07.2015 - 11.2019
Receptionist
Herrin-Gear Toyota
03.2014 - 07.2015
Some College (No Degree) - General Studies
Holmes Community College
High School Diploma -
Northwest Rankin High School
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