Open to opportunities

Jennifer Smith

@jennifersmith6

Message

Experienced prior authorization and utilization review specialist focused on patient access.

United States

Message

What I'm looking for

I seek roles where I can leverage prior authorization and utilization review expertise to improve patient access, work collaboratively across teams, handle case volume efficiently, and contribute to timely appeals and coverage resolutions.

I am a detail-oriented prior authorization and utilization review specialist with experience supporting behavioral health and specialty-care services. I excel at coordinating insurance approvals, reviewing clinical documentation for medical necessity, and maintaining accurate EMR records while collaborating across clinical and revenue-cycle teams.

Known for professionalism, strong communication, and patient advocacy, I manage a high volume of cases with accuracy and timely follow-up, resolving coverage issues and appeals to remove barriers to patient care.

Experience

Work history, roles, and key accomplishments

Current

Prior Authorization Specialist

Current

Accredo Health Group

Oct 2023 - Present (2 years)

Contact insurers to verify benefits and obtain authorizations for behavioral health and specialty treatments; reviewed clinical documentation for medical necessity and documented outcomes in EMR to support appeals and coverage resolutions.

Utilization Review Insurance Verification Appeals Behavioral Health Criteria Patient Advocacy

Communications Specialist

Stafford Communications Group

May 2022 - May 2023 (1 year)

Served as liaison among patients, insurers, and healthcare clients to streamline prior authorization workflows, composed communications to clarify coverage and appeal outcomes, and collaborated with departments to ensure accurate benefit verification.

Patient Advocacy Insurance Verification Documentation Case Management

Customer Care Coordinator

Stanley Steemer

Sep 2015 - Aug 2021 (5 years 11 months)

Managed scheduling, billing, and follow-up coordination while delivering customer service, trained new employees on CRM and procedures, and maintained organized documentation to support service accuracy and team goals.