Dequetta Griffith
Opelousas,LA
Summary
-Accomplished Insurance/Authorization Specialist with a proven track record at Viemed, enhancing authorization efficiency and accuracy through strong communication and meticulous attention to detail. Expert in insurance verification and HIPAA compliance, I significantly contributed to revenue growth and streamlined processes, demonstrating exceptional teamwork and problem-solving skills.
-Health and wellness professional with strong background in guiding individuals to achieve optimal health. Skilled in personalized wellness plans, nutritional guidance, and fitness coaching. Focused on team collaboration and adaptable to changing needs, ensuring reliable support for clients and colleagues. Known for empathetic communication, motivational coaching, and result-driven strategies.
Overview
25
25
years of professional experience
Work History
Insurance/Authorization Specialist
Viemed
Lafayette, La 70508
06.2022 - Current
- Collaborated with healthcare providers to ensure proper documentation for successful authorizations.
- Increased efficiency of the authorization process with effective communication among multidisciplinary teams.
- Streamlined workflow processes for faster turnaround times, using data-driven approaches and continuous improvement techniques.
- Achieved higher accuracy rates in authorizations, utilizing attention to detail and organizational skills.
- Maintained comprehensive knowledge of various insurance plans, ensuring accurate information was provided during the authorization process.
- Contributed to revenue growth, securing necessary authorizations for medical procedures promptly and accurately.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
Financial Intake Specialist/Collections Specialist
LHC Group
Lafayette, LA 70508
06.2013 - 06.2023
- Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
- Maintained accurate, up-to-date client records for reliable reference and communications.
- Reduced errors in documentation through diligent proofreading before submission, maintaining high standards of quality control throughout the entire intake process.
- Assessed clients' needs and determined eligibility for intake services.
- Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
- Verified insurance eligibility, benefits and patient liabilities for defined services for home health
- July 2022-June 2023 Maintained accurate records of all collections activities in the system database.
- Verified customer account balances and processed payments accordingly.
- Improved existing collections processes by analyzing rejection patterns and denials
Verification/Prior Authorization Coordinator
Amedisys Home Health
Baton Rouge, LA
06.2016 - 06.2022
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
- Reduced errors in documentation by meticulously reviewing medical records and verifying patient information.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Collected and processed patient liability statements prior to service.
- Verified eligibility and compliance with authorization requirements for service providers.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
- Optimized turnaround times for prior authorization requests, collaborating closely with physicians and clinical staff to expedite necessary treatments.
- Demonstrated exceptional problem-solving skills, addressing challenges related to patient care coordination and insurance requirements with a solutions-oriented mindset.
- Input all patient data regarding claims and prior authorizations into system accurately.
Optician/Prior Authorization Specialist
Walmart
Opelousas, LA
06.2000 - 06.2013
- 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.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Assisted customers with selecting frames and lenses that best suited their needs
- Performed basic vision screening to determine patient's prescription needs
- Ordered stock from suppliers based on customer orders
Education
Health
ISSA Certified Personal Trainer
05-2024
Administrative Specialist
United States Army Reserve
Baton Rouge, LA08-2003
Associate of Science - Medical Assisting
Remington College
Lafayette, LA05-1997
Skills
- Strong communication skills
- HIPAA compliance
- Active listening
- ICD-10 coding
- Insurance verification expertise
- Documentation management
- Medical terminology proficiency
- Physician order verification
- Knowledgeable in Bonafide and HomecareHomebase systems
- Prescription coordination
- Teamwork and collaboration
- Multitasking
- Fitness trained
- Motivate and inspire in health and wellness
Timeline
Insurance/Authorization Specialist
Viemed
06.2022 - Current
Verification/Prior Authorization Coordinator
Amedisys Home Health
06.2016 - 06.2022
Financial Intake Specialist/Collections Specialist
LHC Group
06.2013 - 06.2023
Optician/Prior Authorization Specialist
Walmart
06.2000 - 06.2013
Health
ISSA Certified Personal Trainer
Administrative Specialist
United States Army Reserve
Associate of Science - Medical Assisting
Remington College
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