Sabrina Griffin
Thomasville
Summary
Healthcare Operations Professional with experience supporting prior authorization, benefit investigation, and reimbursement processes across medical and pharmacy benefit landscapes. Proven ability to review and validate clinical and insurance documentation, track payer requirements, and ensure accurate data entry in HIPAA-compliant systems. Strong background in patient access support, cross-functional collaboration, and remote workflow execution with an emphasis on quality, accuracy, and timeliness.
Overview
5
5
years of professional experience
Work History
Prior Authorization Specialist
Medquest
06.2025 - Current
- Follow through on authorization denials and rejections, supporting appeals and resubmissions as required.
- Collaborated with healthcare providers to clarify documentation requirements for timely approvals.
- Utilized electronic health record (EHR) systems to track authorization status and patient information.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Coordinated with billing department to resolve discrepancies related to denied claims due to incomplete or incorrect prior authorizations.
- Collaborate closely with internal teams to resolve escalations and ensure timely patient access to services.
Patient Access Specialist
Luna Physical Therapy
02.2021 - 06.2025
- Maintained up-to-date knowledge of healthcare regulations and compliance standards to ensure operational efficiency.
- Collaborated with clinical staff to streamline patient intake processes and enhance overall service delivery.
- Coordinated appointment scheduling to optimize clinic workflow and minimize patient wait times.
- Trained new team members on systems and protocols, fostering a collaborative work environment.
- Implemented process improvements that reduced administrative errors in patient registration procedures.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
Benefits Investigation Specialist
Conduent
01.2021 - 08.2024
- Conducted thorough benefits investigations to ensure accurate and timely information delivery.
- Collaborated with healthcare providers to validate patient eligibility and coverage details.
- Utilized electronic health records systems to streamline data retrieval processes.
- Implemented process improvements that reduced investigation turnaround time and increased accuracy of outcomes.
- Established strong relationships with healthcare providers, insurers, and other stakeholders to facilitate smooth handling of benefit investigation cases.
- Managed a high volume of cases simultaneously, prioritizing tasks effectively to meet strict deadlines and maintain high-quality service standards.
- Partnered with benefits analyst and resolved data and system issues pertaining to employee benefits.
Education
High School Diploma -
Southwest Guilford HS
Greensboro, NC01-2013
Skills
- Enrollment & Application Processing
- Insurance verification
- Prior authorization process
- Benefit Investigation Support
- Insurance Verification & Coverage Review
- Medical appeals handling
- Medicare, Medicaid & Commercial Plans (Working Knowledge)
- Financial Assistance Screening & Guidance
- HIPAA Compliance & Secure Record Handling
- Escalation Handling & Issue Resolution
- Medical terminology
- Payer & Plan Issue Tracking
- Provider & Pharmacy Coordination
- High-Volume Case Management
- Microsoft Word, Outlook & Excel
- Data Entry Accuracy & Quality Assurance
- Team Collaboration & Cross-Functional Support
Timeline
Prior Authorization Specialist
Medquest
06.2025 - Current
Patient Access Specialist
Luna Physical Therapy
02.2021 - 06.2025
Benefits Investigation Specialist
Conduent
01.2021 - 08.2024
High School Diploma -
Southwest Guilford HS