Meagan Bowens
Upper Marlboro
Summary
Seasoned healthcare professional with 17 years of experience in clinical and administrative roles, seeking a Prior Authorization Specialist position. Expertise in obtaining authorizations, managing surgical schedules, and verifying insurance details. Proficient in ICD/CPT coding, medical documentation, and coordinating with providers for authorization processes.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Clinical Insurance Reviewer
Maryland Oncology Hematology
10.2020 - 06.2025
- Conduct comprehensive insurance verification and authorization processes to ensure coverage for oncology and hematology treatments, while maintaining compliance with healthcare regulations and providing timely support to patients and healthcare providers.
- Obtaining appeals for denied authorizations for Oncology Infusions by following the Healthcare plan guidelines.
- Ability to review/work hold bills and rejections by providing additional clinical information along with a letter of medical necessity from the physician.
- Insurance Verification: Medicare Part A, B, C, D, Medicaid and Commercial
- I have expertise on ERISA regulations
- Expertise on Areas of Appeals
- Obtain prior authorization for Proton therapy treatments, as required through patients insurance carrier or appropriate third party vendor
- Review and submit, if required, cancer registry documents for auth approval
Medical Office Coordinator for Plastic Surgery
AAMG Plastic Surgery
09.2019 - 09.2020
- Coordinate insurance authorizations and referrals, ensuring compliance with varied patient insurance requirements and facilitating timely access to surgical procedures.
- Prepare accurate surgical posting sheets incorporating ICD-10 and CPT codes to streamline billing processes and support the surgical team's operational efficiency.
- Manage physician's surgical calendar and communication channels, including fielding incoming calls and processing messages within Epic and Athena healthcare systems.
Prior Authorization Representative
International Airport
02.2019 - 08.2019
- Reviewed and processed prior authorization requests, ensuring comprehensive documentation and accurate categorization for standard or expedited medical review.
- Coordinated with healthcare providers to obtain necessary clinical documents and communicated authorization decisions effectively, maintaining meticulous records within the member management system.
Surgical Authorization Representative
Maryland Center for Digestive Health
02.2018 - 02.2019
- Managed surgery scheduling for multiple physicians, ensuring accurate maintenance of daily schedules and patient information using Epic and GMed systems.
- Verified medical coding for procedures, including ICD-10/CPT codes, and secured necessary referrals and authorizations for surgical procedures from health plans.
- Handled patient financial responsibilities by posting health plan payments, collecting copays and deductibles, and arranging payment plans for those with high deductibles.
Medical Administrative Assistant
Washington Ortho & Sports Medicine
08.2014 - 08.2018
- Managed patient registration and financial transactions, ensuring the accurate collection of copays and balances due.
- Conducted comprehensive insurance verifications, including for commercial insurances and managed care, and verified coverage details such as deductibles and out-of-pocket expenses.
- Provided support for clinical staff and assisted patients with administrative needs, including facilitating prior authorizations for therapy and aiding with paperwork completion.
Medical Assistant
LHM Dermatology
06.2011 - 08.2014
- Assisted physicians during examinations and procedures, ensuring efficient patient flow and aiding in biopsies and excision surgeries.
- Performed administrative duties such as coding ICD-9/CPT, scheduling surgeries, verifying insurance, and managing patient intake and scheduling.
- Maintained clinical environment, including sterilizing surgical instruments, preparing exam rooms, and managing inventory of medical supplies and medications.
Medical Assistant
Lindquist Dermatology
12.2009 - 02.2011
- Managed patient flow by triaging, scheduling appointments and surgeries, and preparing examination rooms, ensuring efficient practice operations and patient care.
- Conducted clinical responsibilities including sterilization of surgical instruments, specimen collection, and wound care, while maintaining accurate medical coding and account management.
Medical Insurance Coordinator
Greater Chesapeake Orthopedics
02.2007 - 09.2009
- Managed insurance processes, including verifications, authorizations, and pre-authorizations for medical procedures, ensuring compliance with industry-standard CPT and ICD-9 coding.
- Handled financial transactions, which involved collecting outstanding debts and accurately posting payments from both patients and insurance companies.
Education
undefined
Everest Institute
Silver Spring, MD12.2009
Bachelor's - Accounting
Franklin Pierce University
Rindge, NH06.2000
High school or equivalent - undefined
Old Mill Senior High School
Millersville, MD05.1996
Skills
- Insurance Verification
- Front desk
- Athenahealth
- Knowledge of ICD-10 and CPT codes
- Denial Follow Up
- EMR Systems
- Microsoft Office
- Multitasking
- Communication
- CPT/ICD 10 Coding
- Data Entry
- Time Management
- Glucose Testing
- Surgical Tray Set Up
- Transcription
- Experience Administering Injections
- ICD-10
- Vitals
- Icd-9
- Customer Service
- English
- Microsoft Word
- Epic
- Blood Draws
- Microsoft Outlook
- Medical Terminology
- CPT coding
- ICD coding
- Pregnancy Testing
- Write Offs
- Problem-Solving
- Payment Posting
- EHR systems
- Attention to Detail
- Outpatient
- Allscripts
- Charting
- Medical Scheduling
- Microsoft Excel
- Medical Office Experience
- HIPAA
- Surgical Aseptic Washing and Gloving
- Ear Irrigation
- Phone etiquette
- Debt Collections
- Organizational skills
- Medical Records
- Urinalysis
- HCPCS
- Office experience
- Managed Care
- Clerical Experience
- Insurance payment posting
- Medical billing coding
Certification
- Certified Medical Assistant
- CPR Certification
Timeline
Clinical Insurance Reviewer
Maryland Oncology Hematology
10.2020 - 06.2025
Medical Office Coordinator for Plastic Surgery
AAMG Plastic Surgery
09.2019 - 09.2020
Prior Authorization Representative
International Airport
02.2019 - 08.2019
Surgical Authorization Representative
Maryland Center for Digestive Health
02.2018 - 02.2019
Medical Administrative Assistant
Washington Ortho & Sports Medicine
08.2014 - 08.2018
Medical Assistant
LHM Dermatology
06.2011 - 08.2014
Medical Assistant
Lindquist Dermatology
12.2009 - 02.2011
Medical Insurance Coordinator
Greater Chesapeake Orthopedics
02.2007 - 09.2009
undefined
Everest Institute
Bachelor's - Accounting
Franklin Pierce University
High school or equivalent - undefined
Old Mill Senior High School
Similar Profiles
Isatou A. NYANGIsatou A. NYANG
CLINICAL RESEARCHER at Maryland Oncology HematologyCLINICAL RESEARCHER at Maryland Oncology Hematology
CHANICE NOBLECHANICE NOBLE
Practice Manager at Maryland Oncology HematologyPractice Manager at Maryland Oncology Hematology
Tameka JenkinsTameka Jenkins
Patient Benefits Coordinator at Maryland Oncology HematologyPatient Benefits Coordinator at Maryland Oncology Hematology
Tania ColeTania Cole
Employment Specialist at Ardmore EnterprisesEmployment Specialist at Ardmore Enterprises
Jaelyn VinesJaelyn Vines
Social Studies Teacher at Scotlandville Middle Pre-Engineering Magnet AcademySocial Studies Teacher at Scotlandville Middle Pre-Engineering Magnet Academy