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Lori Zobel

@lorizobel

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Prior Authorization Specialist at Optum Rx processing 20–25 requests daily for Medicare and Commercial plans.

United States

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What I'm looking for

I'm seeking a full-time remote position where I can contribute my prior authorization and healthcare operations experience to accurate, efficient service.

At Optum Rx, I process approximately 20–25 prior authorization requests daily for Medicare and Commercial plans. I review requests against payer policies, clinical guidelines, and evidence-based criteria, coordinating submissions through CoverMyMeds.

I work with physician offices to confirm fax information, check authorization status, request urgent handling, and resolve submission questions. I also explain next steps to members, including how to pursue an appeal when additional review is needed.

Previously, as a Clinical Administrative Coordinator at Optum Rx, I supported HouseCalls operations by scheduling in-home appointments and educating members about preventive-care services, benefits, and appointment requirements.

At Wag!, I handled safety and compliance concerns, escalations, and incident investigations, and earlier provided customer service. I hold an Associate of Arts in General Studies and am CPD Certified in Basics of Medical Billing & Coding.

Experience

Work history, roles, and key accomplishments

Current

Prior Authorization Specialist

Current

Optum Rx

Aug 2024 - Present (2 years 2 months)

Process approximately 20–25 prior authorization requests daily in a high-volume Pharmacy Benefit Manager environment. Review requests using payer policies and clinical criteria, coordinate through CoverMyMeds, and communicate with physician offices and members.

Prior Authorizations Utilization Management Pharmacy Benefits CoverMyMeds Zendesk Genesys Amazon Workforce HIPAA Insurance Verification Provider Relations Member Services Claims Support Care Coordination Process Improvement Remote Work

Clinical Administrative Coordinator

Optum Rx

Oct 2022 - Aug 2024 (1 year 10 months)

Supported Optum Rx HouseCalls operations through in-home appointment scheduling and coordination. Educated members about preventive-care services and benefits, and resolved scheduling and service issues while maintaining HIPAA compliance.

Care Coordination Scheduling Member Education HIPAA compliance Communication Skills Problem Solving

Compliance & Safety Representative

Wag!

Mar 2021 - Apr 2022 (1 year 1 month)

Handled safety and compliance-related concerns, escalations, and incident investigations in a high-volume customer support environment. Reviewed reported issues, documented case information, and supported resolution and follow-up.

Compliance Safety incident investigation Customer Support Documentation Escalation Management

Customer Service Representative

Wag!

Sep 2018 - May 2020 (1 year 8 months)

Provided customer service support in a high-volume environment, responding to customer questions and resolving service-related concerns. Investigated issues, explained options, and documented interactions.

Customer Service Communication Skills Issue Resolution Documentation Empathy

Member Service Representative

DialAmerica

Provided member/customer service support, answered questions, and assisted with issue resolution. Documented interactions and communicated information clearly in a high-volume service environment.

Customer Service Communication Skills Documentation Issue Resolution

Member Service Representative

Young Living Essential Oils

Supported members with account and service questions and provided customer-focused assistance. Resolved routine concerns while maintaining accurate information and professional communication.

Customer Service Communication Skills Account Support Problem Solving