INDIA JONES
Belzoni,MS
Summary
High-performing Prior Authorization Representative II Specialist with over 10 years of customer service experience and a proven track record of exceeding productivity benchmarks while maintaining exceptional quality. Skilled in RX claims processing, insurance verification, and navigating complex healthcare systems in fast-paced environments.
Overview
11
11
years of professional experience
Work History
Prior Authorization Representative II
CVS Health
Remote
01.2021 - Current
- Exceeded productivity benchmark (3.6 QPH) achieving 5.5 QPH with only 2 errors annually
- Process prior authorizations with high accuracy and compliance
- Review RX claims and insurance documentation across multiple systems
- Utilize MedCompass, MHK, and LexisNexis for efficient case handling
- Resolve complex issues with providers and insurance representatives
Customer Service Representative
Sitel / Conduent
Remote
01.2015 - 01.2020
- Managed high-volume inbound and outbound calls across multiple campaigns
- Provided billing, technical support, and account assistance
- Maintained high customer satisfaction and resolution rates
- Supported brands including Starbucks, DirecTV, Xerox, and Alight
Education
Diploma -
Humphreys County High School
Belzoni, MS05.2003
Skills
- Fax & Email Queue
RX Claims
Medical Terminology
Data Accuracy
Customer Relations
Conflict Resolution
Microsoft Office
MedCompass & MHK
LexisNexis
Oracle Systems
Five9 / Cisco
Fax & Email Queue
Timeline
Prior Authorization Representative II
CVS Health
01.2021 - Current
Customer Service Representative
Sitel / Conduent
01.2015 - 01.2020
Diploma -
Humphreys County High School