Toria Powell
Cary
Summary
Dynamic Reimbursement Specialist with extensive experience at Mercallis, excelling in insurance verification and pre-authorization management. Proven ability to resolve complex billing inquiries while maintaining HIPAA compliance. A fast learner and reliable team player, adept at leveraging Excel for efficient data management and enhancing patient support services.
Overview
10
10
years of professional experience
Work History
Reimbursement Specialist
Mercallis
Morrisville
11.2023 - 04.2025
- Verified patient insurance coverage, benefits, and eligibility for services across multiple insurance platforms.
- Liaised with insurance companies to obtain pre-authorizations for procedures and medications.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Maintained updated knowledge through continuing education and advanced training.
Patient support advocate
Cigna
01.2019 - 01.2023
- Processing incoming claims
- Pre-authorization request
- Research billing inquiries/Issues
- Manage high call volume
- Type 60 wpm
- Proficient in excel/power point/ sales force/ Microsoft office & a number of other software systems
- Fast learner/ reliable.
Prescription Services Coordinatorw
Imagine360
01.2015 - 01.2019
- Coordinate pharmacy benefit changes provide status updates for all ongoing pharmacy setups
- Resolve helpdesk tickets via rx service queue.
Education
High School Diploma -
Westchester Community College
Valhalla, NY05-2019
Graduate Certificate - Medical Assisting
Mandl School of Allied Health
New York, NY09-2004
Skills
- Insurance verification
- Claims processing
- Pre-authorization management
- HIPAA compliance
- Excel spreadsheet management
- Billing inquiry resolution
Languages
English
Professional
Timeline
Reimbursement Specialist
Mercallis
11.2023 - 04.2025
Patient support advocate
Cigna
01.2019 - 01.2023
Prescription Services Coordinatorw
Imagine360
01.2015 - 01.2019
High School Diploma -
Westchester Community College
Graduate Certificate - Medical Assisting
Mandl School of Allied Health
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