LAURE MURDOCK
San Tan Valley
Summary
ELECTRONIC FILING OF CLAIMS, PROFICIENT MEDICAL TERMINOLOGY KNOWLEDGE, 10 KEY PUNCH BY TOUCH, DEVELOPED INTERPERSONAL SKILLS, TEAM PLAYER, SELF - STARTER AND EXCELLENT ANALYTICAL SKILLS. CLEARANCE AND SOFTWARE: PREVIOUSLY HELD A LEVEL 2 NAC (DOD), EXCEL, MICROSOFT WORD, WINDOWS, MEDISOFT, ICM, MS4 CERNER MILLENNIUM, NEXTGEN, PEGA, CAREONE, PCH, RUMBA (PIMS), VA DARTA SUITE, CCM, CSP FACETS, ICUE,NDB, EDSS, nPRL, NDB AND OTHER VARIOUS MEDICAL RECORDS PROGRAMS. OUTLOOK, MS TEAMS
Overview
20
20
years of professional experience
Work History
Provider Data Specialist
Optum Services
Phoenix
09.2021 - Current
- Support day-to-day provider data operations for load and maintenance of data supporting provider networks for medical, behavioral, physical, dental, and vision services.
- Coordinate with leadership to complete assigned work.
- Execute assigned data management tasks with a high degree of proficiency and accuracy.
- Complete load and maintenance of complex provider data requests as required for multiple networks.
- Assist the supervisor as needed with daily analysis and operations within the department adherence to department and organizational policies.
- Promote a positive work environment within the department.
- I am also involved in special projects such as the SOP governance board and F4 report clean up as well as being cross trained with cross referencing provider profile accounts. I have experience with nPRL.
Pharmacy Care Coordinator
Optum Rx
Phoenix
09.2020 - 10.2021
- Contact patients by phone to assist with medication ordering. Both outbound and inbound calls are made/received.
- Research patient accounts to determine a cause for refill non-compliance.
- Conduct calls according to procedures outlined in the quality guidelines.
- Maintain focus and stay on task throughout the day in order to meet desired metrics and remain productive.
- Collaborate with team members and supporting departments to resolve conflict and ensure customer needs are satisfied in a timely manner.
- Manage time effectively to meet both team metrics and company guidelines without constant supervision.
Clinical Administrative Coordinator
United Healthcare Community & State
Phoenix
05.2017 - 09.2020
- Review, research and resolve denied claims and notification requirements for inpatient/outpatient procedures, transition of care and network gap issues.
- Set up documents/triage cases for (CCR) Clinical Claim Review.
- Assist with correspondence letters, faxes and emails.
- Verify and use appropriate ICD-10 and CPT coding.
Prior Authorization Coordinator
United Healthcare Military & Veterans
Phoenix
04.2015 - 05.2017
- Processed prior authorization requests for active duty service members.
- Processed line of duty requests faxed in by the Department of Defense.
- Completed notification wizard along with ICD-10 and CPT coding.
- Assisted the nurse group with end of day faxes to Express Scripts.
- Provided excellent customer service, UM specialty escalations and acting SME as directed by supervisor when needed.
- Cross trained in numerous specialties such as behavioral health, durable medical equipment and dependent authorizations to be able to assist other departments as needed.
- Level 2 NAC with the Department of Defense.
Customer Service Representative / Insurance Collector
Arizona Pediatric Eye Specialists
Mesa
02.2014 - 02.2015
- Processed patient and insurance carrier payments, and various other administrative supports.
- Answered phone calls from patients and insurance representatives.
- Collaborated with insurance representatives and patients to resolve account issues and questions.
- Compiled reports, appeals and processed electronic and physician claims.
- Maintained online patient database and office files.
Customer Service Representative for BCBS / Tricare / Work Comp and the Veterans Administration Group
Banner Healthcare
Mesa
04.2010 - 01.2013
- Ensured excellent customer service while collecting monies due from patient insurance carriers.
- Worked closely with the VA fee service offices to clear outstanding claims and authorizations.
- Answered incoming calls from patients and insurance representatives in regards to insurance billing questions.
- Processed A/R reports, followed up on claims, appeals, resolved patient account issues, questions, and electronic claim filings.
Credit and Customer Service
Macy's
Tempe
09.2006 - 04.2010
- Resolving charge disputes for customers' credit accounts.
- Initiate inquiries on deliveries not received and coordinate reorder / reship.
- Collected monies on past due accounts while ensuring excellent customer service.
- Set up customers on payment plans and resolved customer issues with accounts.
- Took incoming calls and placed orders for customer satisfaction.
Education
Diploma - GENERAL STUDIES
FLAGSTAFF HIGH SCHOOL
FLAGSTAFF, AZFunctional Summary
ELECTRONIC FILING OF CLAIMS, PROFICIENT MEDICAL TERMINOLOGY KNOWLEDGE, 10 KEY PUNCH BY TOUCH, DEVELOPED INTERPERSONAL SKILLS, TEAM PLAYER, SELF-STARTER AND EXCELLENT ANALYTICAL SKILLS. CLEARANCE AND SOFTWARE: LEVEL 2 NAC (DOD), EXCEL, MICROSOFT WORD, WINDOWS, MEDISOFT, ICM, MS4 CERNER MILLENNIUM, NEXTGEN, PEGA, CAREONE, PCH, RUMBA (PIMS), VA DARTA SUITE, CCM, CSP FACETS, ICUE, NDB, EDSS AND OTHER VARIOUS MEDICAL RECORDS PROGRAMS. OUTLOOK, MS TEAMS
Timeline
Provider Data Specialist
Optum Services
09.2021 - Current
Pharmacy Care Coordinator
Optum Rx
09.2020 - 10.2021
Clinical Administrative Coordinator
United Healthcare Community & State
05.2017 - 09.2020
Prior Authorization Coordinator
United Healthcare Military & Veterans
04.2015 - 05.2017
Customer Service Representative / Insurance Collector
Arizona Pediatric Eye Specialists
02.2014 - 02.2015
Customer Service Representative for BCBS / Tricare / Work Comp and the Veterans Administration Group
Banner Healthcare
04.2010 - 01.2013
Credit and Customer Service
Macy's
09.2006 - 04.2010
Diploma - GENERAL STUDIES
FLAGSTAFF HIGH SCHOOL