Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Sherami Dana

Nampa

Summary


Results-driven healthcare professional with expertise in prior authorization processes and employee training. Skilled in supervising teams, ensuring policy compliance, and optimizing workflows to meet key performance metrics. Adept at monitoring productivity, resolving barriers, and enhancing team communication to drive operational efficiency and service quality. Committed to fostering a high-performance culture in alignment with organizational goals.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Prior Authorization Specialist

St Alphonsus Regional Medical
07.2017 - Current
  • Collaborated closely with office staff and physicians to gather essential clinical information required for accurate and timely prior authorization submissions.
  • Maintained up-to-date knowledge of various insurance plan requirements to ensure proper documentation and prevent delays in patient care.
  • Reviewed and analyzed medical records and related documentation to support medical necessity and facilitate approval of authorization requests.
  • Verified patient eligibility and ensured service providers met compliance standards for authorization, reducing claim denials and improving workflow efficiency.

Scheduling Lead

St Alphonsus Regional Medical
10.2014 - 07.2017
  • Effectively communicated with physicians, patients, office staff, and hospital departments to coordinate and schedule outpatient diagnostic testing.
  • Provided clear guidance and timely assistance in resolving scheduling issues and addressing inquiries, ensuring smooth operations and patient satisfaction.
  • Built strong relationships with patients and referring offices, fostering trust and collaboration through consistent and professional communication.
  • Actively participated in LEAN process improvement projects, contributing to the development and implementation of more efficient workflows aimed at enhancing the patient experience and operational efficiency.

Outpatient Scheduling Department

Saint Alphonsus Regional Medical Center-Nampa
09.2009 - 10.2014
  • Answered high-volume phone calls in a fast-paced environment while delivering friendly, professional customer service to patients, providers, and staff.
  • Coordinated scheduling of technicians and hospital rooms for outpatient diagnostic testing, ensuring efficient use of resources and minimal delays in patient care.

Education

High School Diploma -

Star Valley High School
Afton, WY

Elementary Education

Utah Valley University
Orem, UT

Skills

  • Prior authorization process
  • Medical terminology
  • Medical coding expertise
  • Insurance verification
  • Medical terminology knowledge
  • Effective communication skills
  • Professionalism and ethics
  • Precertification requirements
  • Trained new hires on end-to-end prior authorization processes, including system usage and payer guidelines

Certification

Certified Professional Coder

Aug 18, 2018

Timeline

Prior Authorization Specialist

St Alphonsus Regional Medical
07.2017 - Current

Scheduling Lead

St Alphonsus Regional Medical
10.2014 - 07.2017

Outpatient Scheduling Department

Saint Alphonsus Regional Medical Center-Nampa
09.2009 - 10.2014

High School Diploma -

Star Valley High School

Elementary Education

Utah Valley University

Similar Profiles

CREATE PROFILE
Sherami Dana