Lisa McCullough
@lisamccullough
Detail-oriented prior authorizations representative with strong customer service skills.
What I'm looking for
I am an experienced Prior Authorizations Representative with a strong background in managing the prior authorization process across various healthcare settings. My journey began at Paragon Healthcare, where I honed my skills in verifying insurance benefits and coordinating with healthcare providers to ensure timely approvals for patient treatments and medications. My commitment to effective communication has allowed me to resolve issues efficiently, maintaining compliance with regulations while providing exceptional service to patients and providers alike.
Currently, I am working with Sante Health Systems, where I coordinate prior authorization requests, ensuring compliance with insurance regulations and facilitating optimal patient care. My role involves collaborating closely with healthcare providers to gather necessary documentation and analyze patient needs. I take pride in my ability to communicate effectively with both patients and insurance companies, ensuring that all parties are informed and satisfied throughout the authorization process.
With a solid foundation in medical assistance from the Institute of Technology, I have developed a comprehensive understanding of clinical procedures, patient care techniques, and medical office protocols. I am dedicated to continuous improvement and staying updated on changes in insurance policies and best practices, which allows me to navigate complex authorization processes with ease.
Experience
Work history, roles, and key accomplishments
Prior Authorizations Representative/Inbound Calls
Evolent Health
Aug 2024 - Apr 2025 (8 months)
Managed incoming calls to process prior authorization requests, resolved inquiries, and maintained accurate records. Provided exceptional customer service to support patient needs.
Prior Authorizations Coordinator
Sante Health Systems
Mar 2022 - Jun 2022 (3 months)
Coordinated prior authorization requests for medical services, ensuring compliance with insurance regulations and timely approvals. Collaborated with healthcare providers to gather necessary documentation and analyzed patient needs.
Prior Authorizations Representative
Paragon Healthcare
Jan 2018 - Feb 2022 (4 years 1 month)
Managed the prior authorization process by verifying insurance benefits, obtaining necessary documentation, and coordinating with healthcare providers. Ensured timely approval for patient treatments and medications.
Education
Degrees, certifications, and relevant coursework
Institute Of Technology
Medical Assistant Certificate, Medical Assisting
2009 - 2010
Acquired hands-on training in clinical procedures, patient care techniques, and medical office protocols. Developed skills in patient scheduling, medical billing, and record management while mastering vital sign monitoring and laboratory preparation. Enhanced communication and teamwork abilities in diverse healthcare settings.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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