Summary
Overview
Work History
Education
Skills
Timeline
Generic

Kaylin Myre

Sacramento

Summary

Dedicated Utilization Management Coordinator and Prior Authorization Specialist with a proven ability to collaborate effectively with insurance representatives to secure preapproval for medical procedures and testing. Over four years of experience in managing documentation and ensuring compliance, complemented by three years as an Intake Specialist skilled in conducting thorough interviews and efficiently summarizing data. Recognized for exceptional multitasking abilities and a strong commitment to teamwork, fostering a supportive environment that enhances client interactions. Proficient in managing client files and prioritizing tasks to maximize productivity while delivering compassionate assistance tailored to individual needs. Solid foundation in utilization management coordination optimizes resource allocation and enhances patient care through strategic planning.

Overview

7
7
years of professional experience

Work History

Utilization Management Coordinator

Vivant Health
12.2024 - Current
  • Coordinated utilization review processes to ensure compliance with regulatory standards and internal policies.
  • Analyzed patient data to determine eligibility for services, enhancing approval turnaround times.
  • Collaborated with healthcare providers to gather necessary documentation for efficient case management.
  • Implemented workflow improvements that streamlined communication between departments and reduced delays in service delivery.

Prior Authorization Specialist

TEKSystems
01.2022 - 10.2024
  • Processed prior authorization requests efficiently, ensuring adherence to company policies and regulatory guidelines.
  • Collaborated with healthcare providers to gather necessary documentation for authorization approvals.
  • Utilized electronic medical record systems to track and manage authorization statuses effectively.
  • Conducted regular audits of authorization cases, identifying discrepancies and implementing corrective actions.

Senior Intake Specialist

Aston Carter
06.2020 - 01.2022
  • Streamlined appointment scheduling for improved patient experience and reduced wait times.
  • Determine authorization requirements based on company policy, member benefit grid and provider status
  • Conducted thorough insurance verifications to minimize billing errors and financial complications for patients.
  • Enhanced patient satisfaction by efficiently managing intake processes and promptly addressing concerns.

Medical Claims Examiner

Centene
09.2018 - 06.2020
  • Enhanced claim processing efficiency by conducting thorough investigations and maintaining accurate documentation.
  • Reduced claim denial rates by thoroughly reviewing and validating medical documentation before submission.
  • Worked closely with fraud investigation teams to identify suspicious patterns in submitted claims.
  • Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.

Education

High School Diploma -

C.K. McClatchy
Sacramento, CA
06-2014

Skills

  • Healthcare vocabulary expertise
  • Proficient in ICD-10 and CPT coding
  • Clear written communication
  • Detail-oriented data management
  • HIPAA compliance awareness
  • Critical thinking
  • Multitasking efficiency
  • Precision in documentation
  • Understanding of Medicare and Medicaid programs

Timeline

Utilization Management Coordinator

Vivant Health
12.2024 - Current

Prior Authorization Specialist

TEKSystems
01.2022 - 10.2024

Senior Intake Specialist

Aston Carter
06.2020 - 01.2022

Medical Claims Examiner

Centene
09.2018 - 06.2020

High School Diploma -

C.K. McClatchy
Kaylin Myre