Experience

Contra Costa Health Plan

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Health Plan Authorization Representative

  • Feb 2019 - Present

  I investigate policy coverage of pre-service authorization requests. Appropriate requests are then prepared and routed for utilization review. Additionally, I prepare notifications of approvals, revised approvals, inappropriate or incomplete requests and non-covered services. I also provide customer service to all contracted providers by answering all inquries, including status updates, policy and coverage questions, and facilitating any corrections or additions to pre-service authorizations. I investigate policy coverage of pre-service authorization requests. Appropriate requests are then prepared and routed for utilization review. Additionally, I prepare notifications of approvals, revised approvals, inappropriate or incomplete requests and non-covered services. I also provide customer service to all contracted providers by answering all inquries, including status updates, policy and coverage questions, and facilitating any corrections or additions to pre-service authorizations.



Contra Costa County

• United States
• Government Administration
• 700 & Above Employee

• Senior Clerk

  • Jun 2003 - Feb 2019

  I am a Care Coordinator. My role involves providing administrative assistance to a group of physicians that encompasses adult medicine, internal medicine, and family practice. I facilitate referral management and scheduling for specialty medical services, transportation assistance, durable medical equipment procurement, and customer service to clients that come from a wide variety of cultures, ethnicities and backgrounds. I also serve on various committees that promote patient satisfaction and improvements for the saftey-net community that we serve. Show less