Debra Marsetti
Porter Ranch
Summary
Efficient Authorization Specialist with comprehensive knowledge of medical insurance policies, coding and procedures. Demonstrated ability to liaise effectively between patients, healthcare providers, and insurance companies for smooth transactions. Strengths include strong problem-solving skills, thoroughness in documentation and a keen eye for identifying inconsistencies. Proven impact in previous roles includes streamlined authorization processes, improved patient satisfaction rates, and reduced claim denials.
Overview
21
21
years of professional experience
1978
1978
years of post-secondary education
Work History
Authorization Specialist
Care Oregon
Portland
09.2004 - 09.2025
- Reviewed patient information to determine authorization requirements for services.
- Communicated with healthcare providers to gather necessary documentation for approvals.
- Processed authorization requests using electronic health record systems efficiently.
- Assisted in resolving issues related to denied or pending authorization requests.
- Researched patient eligibility, coverage information, and benefit levels.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Provided customer service to internal and external customers related to authorization requests.
- Entered data into electronic medical record system accurately and efficiently.
Education
James Monroe
North Hills, CASkills
- Authorization processing
- Electronic health records
- Documentation management
- Insurance verification
- Medical terminology expertise
- Prior authorization processing
- Documentation and reporting
- Telephone etiquette
- Knowledgeable in QNXT
- Medicaid
Timeline
Authorization Specialist
Care Oregon
09.2004 - 09.2025
James Monroe