Tanisha Lee Ross
Slidell,LA
Summary
Results-driven Prior Authorization Specialist with 14 years of experience in insurance verification, infusion services, and home health. Skilled in securing timely approvals, minimizing denials, and collaborating with clinical teams to ensure accurate and complete documentation. Proven ability to manage high-volume workloads in fast-paced remote environments.
Overview
7
7
years of professional experience
Work History
Prior Authorization Coordinator
Soleo Health
03.2025 - 03.2026
- Verified insurance benefits and eligibility using payor portals, phone outreach, and test claim processing
- Obtained prior authorizations and medical reviews for specialty infusion therapies
- Processed an average of 20+ prior authorizations per day while maintaining accuracy and timeliness
- Coordinated with providers and payors to resolve authorization issues and prevent care delays
- Coordinated prior authorization requests, ensuring compliance with regulatory guidelines and insurance requirements.
- Analyzed patient data to determine eligibility for medication coverage, improving processing efficiency.
- Collaborated with healthcare providers to gather necessary documentation for authorization approvals.
- Streamlined workflows by implementing best practices in prior authorization processes, enhancing departmental productivity.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
Authorization Specialist
Paragon Healthcare
11.2021 - 08.2024
- Processed high-volume prior authorization requests for infusion therapy services
- Collaborated with clinical teams to ensure complete and compliant medical documentation
- Reduced denial rates by improving accuracy and completeness of submissions
- Followed up with insurance companies to expedite approvals and ensure timely patient care
- Processed authorization requests efficiently, ensuring compliance with regulatory guidelines.
- Collaborated with healthcare providers to gather necessary documentation for approvals.
- Utilized electronic health record systems to manage patient information and authorization workflows.
Benefit Verification Specialist
AccentCare
10.2018 - 05.2021
- Conducted comprehensive benefit verification for home health services
- Managed a caseload of 40+ patient cases per day while maintaining accuracy and efficiency
- Calculated and explained patient financial responsibility, improving upfront collections
- Communicated with payors to confirm coverage, limitations, and authorization requirements
- Verified patient benefits information to ensure accurate coverage and eligibility
- Collaborated with insurance providers to resolve discrepancies in benefit verifications
- Streamlined verification processes, enhancing operational efficiency and reducing turnaround time
Education
Diploma -
Sarah T. Reed High School
New Orleans, LASkills
- Prior Authorization & Appeals Support
- Insurance Verification & Eligibility
- Infusion & Home Health Services
- Medicare, Medicaid & Commercial Plans
- Medical Documentation Review
- Payor Communication & Follow-Up
- Denial Prevention & Resolution
- Remote Workflow Management
- Insurance Portals (Availity, NaviNet, Payor Websites)
- Electronic Medical Records (EMR/EHR)
- Microsoft Office (Outlook, Excel, Word)
- Customer service
Timeline
Prior Authorization Coordinator
Soleo Health
03.2025 - 03.2026
Authorization Specialist
Paragon Healthcare
11.2021 - 08.2024
Benefit Verification Specialist
AccentCare
10.2018 - 05.2021
Diploma -
Sarah T. Reed High School