At WELLCARE / CENTENE, I provide day-to-day operational guidance and support, handle complex healthcare authorization inquiries, and serve as an escalation resource for provider and operational issues.
I monitor production and performance metrics, coach team members in real time, and assist with workload distribution and queue monitoring. I also support process improvement initiatives and coordinate operational projects.
Previously, at WELLCARE HEALTH PLANS, INC., I managed authorization inquiries and provider escalations, served as a subject matter expert for authorization workflows, and developed job aids and trained team members.
At WELLCARE, I processed medical and DME prior authorizations, researched CPT codes and CMS Medicare/Medicaid fee schedules, and was recognized as a top producer on the DME team. Earlier, at ADVOCATE MEDICAL SERVICES, I managed client accounts and medical orders, verified insurance information, and processed AP/AR transactions.
