Demetris R. Butler
Baton Rouge
Summary
Dedicated and compassionate professional with vast experience providing medical assistance, office management, and human resource support within a medical environment. Demonstrated competency in patient care, documentation, effective communication. Strategic team player, skilled in managing electronic health record. Extensive experience in Onboarding, staff training, and employee relations. Detail-oriented professional passionate about supporting cutting- edge process that promote the advancement of patient care and the well-being of the community. Professional in healthcare industry, bringing valuable experience in authorization management and compliance. Known for delivering reliable and timely authorizations while maintaining robust communication with healthcare teams. Consistently focused on collaborative efforts and achieving results, ensuring organizational goals are met. Skilled in problem-solving and adaptable to changing requirements.
Overview
20
20
years of professional experience
Work History
Authorization Specialist III
Louisiana Healthcare Connections dba Centene
01.2024 - Current
- Supports authorization request for services in accordance with the insurance prior authorization list
- Supports and performs date entry to maintain and update authorization requests into utilization management system
- Assist utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
- Contributes to the authorization review process by documenting necessary medical information
- Complies with all policies and procedures
Referral Specialist II
Louisiana Healthcare Connections dba Centene
12.2018 - 01.2024
- Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list
- Route to appropriate department when needed
- Answer phone queues and process faxes within established standard
- Data enters authorizations into the system
Supervisor, Referral Services
Louisiana Healthcare Connections
07.2013 - 11.2018
- Supervise the daily operations of the UM staff
- Ensure appropriate usage of resources to facilitate the UM process
- Assist with ensuring consistent data collection from UM staff to assist the company in achieving corporate goals, to improve monitoring and reporting to meet external requirements
- Identify opportunities for process improvements necessary to facilitate department functions
- Educate staff as necessary to ensure consistent performance and adhere to standards
- Assist UM Manager and Director with coordinating and facilitating system processes with providers, partners, vendors, and subcontractors, as necessary
Lead Referral Specialist
Louisiana Healthcare Connections
11.2012 - 06.2013
- Assist in coordinating the daily workflow of the Referral Specialist staff
- Receive, process, and data enter all authorization requests for physician, ancillary providers, and internal requests to determine approval or denial as directed by the Medical Director
- Assist providers, members and/or internal customers with cases pertaining to referral questions, issues, and authorizations
- Performed other duties as assigned
Referral Specialist I
Louisiana Healthcare Connections
01.2012 - 11.2012
- Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list
- Route to appropriate staff when needed
- Verify eligibility and benefits
- Answer phone queues and process faxes within established standards
- Data enters authorizations into the system
Office Manager/ Medical Assistant
Baton Rouge Foot & Ankle Clinic
07.2008 - 02.2011
- Assisted office manager with tracking inventory and restocking examination rooms and stations.
- Facilitated patient flow by notifying provider of patients' arrival, being aware of delays and communicating with patients and clinical staff.
- Enhanced the overall patient experience with friendly service at reception while managing phones lines promptly to answer inquiries or book appointments efficiently.
- Increased patient comfort levels with attentive listening skills while obtaining medical histories and addressing any questions or concerns they may have had.
- Ensured proper follow-up care for patients by diligently scheduling referrals or additional tests as needed.
- Improved overall clinic efficiency by performing clinical duties such as taking vital signs, administering injections, and drawing blood samples.
- Reduced wait times for patients through proficient handling of check-in and check-out processes, ensuring smooth appointment transitions.
- Cross-trained in front-office procedures to back up reception staff.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Enhanced clinic efficiency by assisting physicians with routine procedures and diagnostic tests.
- Maintained strict adherence to infection control protocols by following proper sterilization techniques for medical equipment.
- Optimized appointment scheduling processes to minimize conflicts and maximize physician availability for patients.
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
- Maintained a safe and clean clinical environment by adhering to infection control guidelines and disposing of biohazardous waste properly.
Medical Assistant
Rosemarie Caillier, DPM
07.2005 - 05.2008
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Obtained client medical history, medication information, symptoms, and allergies.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Performed medical records management, including filing, organizing and scanning documents.
Education
General Education Development Certificate -
State of Louisiana
Baton Rouge, LA01.2011
Diploma - Medical Assistant
Baton Rouge School of Computers/Spencer College
Baton Rouge, LA01.1994
Diploma - Medical Office Administration
Delta College of Arts & Technology
Baton Rouge, LA01.1992
Skills
- Medical terminology expertise
- Claims management
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
Timeline
Authorization Specialist III
Louisiana Healthcare Connections dba Centene
01.2024 - Current
Referral Specialist II
Louisiana Healthcare Connections dba Centene
12.2018 - 01.2024
Supervisor, Referral Services
Louisiana Healthcare Connections
07.2013 - 11.2018
Lead Referral Specialist
Louisiana Healthcare Connections
11.2012 - 06.2013
Referral Specialist I
Louisiana Healthcare Connections
01.2012 - 11.2012
Office Manager/ Medical Assistant
Baton Rouge Foot & Ankle Clinic
07.2008 - 02.2011
Medical Assistant
Rosemarie Caillier, DPM
07.2005 - 05.2008
General Education Development Certificate -
State of Louisiana
Diploma - Medical Assistant
Baton Rouge School of Computers/Spencer College
Diploma - Medical Office Administration
Delta College of Arts & Technology
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