MARY MURRIE
Marion
Summary
Dynamic Prior Authorization Specialist at Everise/Navitus with a proven track record in streamlining workflows and enhancing efficiency. Skilled in insurance verification and adept at problem-solving, I excel in delivering exceptional customer service while ensuring compliance with HIPAA regulations. Committed to achieving optimal outcomes in fast-paced environments.
Overview
6
6
years of professional experience
Work History
Prior Authorization Specialist
Everise/Navitus
Marion
01.2025 - Current
- Streamlined workflows to improve efficiency in authorization processes.
- Reviewed prior authorization requests for accuracy and completeness of required information.
- Evaluated prior authorization requests for medical services and medications.
- Verified patient insurance coverage, including eligibility, benefits, and authorizations.
- Processed appeals promptly according to policy guidelines.
Customer Service Representative
Everise
Marion
09.2024 - Current
- Handled customer complaints and inquiries in a courteous and efficient manner.
- Demonstrated excellent communication skills, both verbal and written, in order to effectively interact with customers.
- Developed strong customer relationships and loyalty through effective communication.
- Maintained knowledge of company products to provide helpful suggestions and recommendations to customers.
- Greeted customers by name and displayed respectful attitude, helping develop rapport with customer base and build lasting relationships.
- Utilized problem-solving techniques to identify solutions for complex customer inquiries.
- Adhered to company policies and procedures while providing superior service.
- Assisted customers with product selection by providing detailed information about available products and services.
- Maintained an updated knowledge base of current products, services, pricing, promotions.
- Met daily customer service quotas with a focus on quality.
- Remained open to feedback from supervisor and peers to build and improve skills set.
- Developed and maintained working knowledge of internal policies, procedures, and services to appropriately address customer issues.
- Delivered personalized customer service relating to questions and promptly resolved basic problems on customer accounts.
- Logged details of customer service calls in computer system following correct protocols.
- Complied with corporate and regulatory policies regarding information confidentiality and privacy.
Front Desk Receptionist
SI Neurology & Sleep Medicine
Carbondale
12.2023 - 05.2024
- Greeted and welcomed visitors in a professional manner while managing multiple tasks simultaneously.
- Provided a high level of customer service to all clients.
- Managed incoming calls, directing them to appropriate staff members or taking detailed messages as necessary.
- Processed payments received from customers via cash or credit card transactions accurately and efficiently.
- Maintained an organized front desk area, ensuring all forms were up to date and available for visitors.
- Completed daily documentation and charts regarding patient care and input reports into practice databases.
- Measured patient vital signs, recording body temperature, blood pressure, and heart rate.
- Followed HIPAA regulations to maintain confidentiality of sensitive medical and personal information.
- Processed prior authorizations requests within established time frames.
- Provided excellent customer service to patients via phone, email, or in person inquiries.
- Prepared and processed authorization forms for various insurance companies, ensuring accuracy of information.
- Maintained up-to-date knowledge of insurance guidelines and regulations.
- Assisted with appeals process when necessary by providing required documentation to insurance companies.
- Tracked progress of pending cases through the authorization process.
- Analyzed patient records to determine eligibility for health care services.
Enrollment Specialist
Connexion Point
10.2023 - 12.2023
- Compiled data for reports on enrollment trends, demographics and retention rates.
- Reviewed applications for accuracy before submitting to appropriate entities for processing.
- Performed research activities in order to identify trends related to Medicare enrollments.
- Identified areas of improvement within the Medicare enrollment process and implemented solutions accordingly.
- Provided clear, concise, and up-to-date information to customers on the Medicare enrollment process.
- Demonstrated proficiency in using various software programs such as Microsoft Office Suite.
- Maintained an organized, clean, safe working environment by following company safety standards.
- Built strong relationships with customers through friendly interactions.
- Demonstrated ability to work in a fast-paced environment and multitask efficiently.
- Efficiently handled multiple tasks simultaneously while maintaining attention to detail.
- Developed excellent customer service skills, including problem solving and conflict resolution.
- This was a seasonal role.
Customer Advocate
HCSC BCBS
Marion
06.2019 - 06.2021
- Determined customer needs by assessing issues through appropriate questioning.
- Explained benefit programs and eligibility requirements to employees.
- Assisted with claims processing and resolving any discrepancies or issues that arose.
- Responded to benefit inquiries from employees on plan provisions, benefits enrollments and status changes.
- Provided assistance with open enrollment processes and answered questions regarding eligibility requirements.
- Guided employees through the enrollment process for all benefit programs.
- Assisted employees regarding benefits claim issues and plan changes.
- Developed effective communication and problem-solving skills while interacting with customers.
- Analyzed complex medical records from a variety of sources to determine eligibility for health care coverage.
- Provided excellent customer service by addressing questions or concerns promptly and courteously.
- Utilized strong organizational skills to efficiently manage workflow processes within established timelines.
- Utilized computer systems to accurately process applications, verify information, and update records.
Education
High school diploma - GED
Herrin High School
Herrin, IL05.2009
Some College (No Degree) - Medical Billing And Coding
DeVry University
OnlineSkills
- Microsoft Office Suite
- Punctuality and reliability
- Script adherence
- De-escalation techniques
- Problem-solving
- Scheduling
- Customer service
- [Software] CRM system proficiency
- Inbound and outbound calling
- High-energy attitude
- Appointment scheduling
- Typing proficiency
- Microsoft office expertise
- POS systems expert
- Active listening
- Data collection
References
References available upon request
Timeline
Prior Authorization Specialist
Everise/Navitus
01.2025 - Current
Customer Service Representative
Everise
09.2024 - Current
Front Desk Receptionist
SI Neurology & Sleep Medicine
12.2023 - 05.2024
Enrollment Specialist
Connexion Point
10.2023 - 12.2023
Customer Advocate
HCSC BCBS
06.2019 - 06.2021
High school diploma - GED
Herrin High School
Some College (No Degree) - Medical Billing And Coding
DeVry University
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