Heather R. Hamel
Warrenton
Summary
Seeking position as a prior authorization specialist
Excellent communication skills, sincere commitment to providing quality customer service, and the ability to work effectively and cooperatively as a team member. Handling and processing large sets of data efficiently, generating reports (monthly, quarterly, yearly),obtaining precertification authorizations through phone and web portals
Overview
15
15
years of professional experience
Work History
Prior Authorization Specialist (Medix Contract)
Ivy Rehab
11.2025 - 11.2025
- Worked fully remote and independently to ensure prior authorizations were obtained in a timely manor
- Reviewed and processed prior authorization requests ensuring compliance with insurance guidelines.
- Collaborated with healthcare providers to obtain all necessary documentation
- Utilized electronic health record systems to track and manage authorization workflows efficiently. Pulled daily work flow reports to check authorization status
- Worked in commercial insurance web portals
Patient Experience Coordinator
Athletico Physical Therapy
11.2018 - 08.2025
- Ensure that the front office runs smoothly and efficiently by checking in patients, collecting copays/account balances, manage insurance-based questions, registering new and existing patients, running daily work flow reports, and obtaining prior authorizations
- Ensure patients' needs were met in a friendly and professional manner
- 7 years of experience handling all commercial prior authorizations and work comp authorizations
- Worked daily through major insurance portals including Carelon, United healthcare, ASHlink, Cohere, RadMD, Corvel care IQ, Onecall WC, Humana Military
- Called insurance companies to obtain authorization if needed as well as set up peer to peer to appointments
- Served as Trainer for new rehabilitation aides and new PEC's when available
- Schedule appointments to keep compliant with the therapist recommended plan of care
Receptionist
Center for Bone and Joint Surgery
05.2016 - 10.2018
- Checked in patients as they arrived, ensured the patient's documentation and chart was in order.
- Checked out patients and made follow up appointments requested by the doctor.
- Ensured patients' needs were met in a friendly and professional manner
- Scheduled appointments for patients with facility physicians
- Called primary care physician offices to obtain patient referrals for each visit
- Ensured all documentation was kept confidential and compliant with insurance regulations
- Served as Trainer for new front desk employees
Patient Access Representative
Delray Medical Center
05.2015 - 03.2016
- Registered patients as they arrived at the Medical Center, ensuring documentation was in order.
- Ensured patients' needs were met in a friendly and professional manner
- Managed phone system/ switch board
- Scheduled appointments for patients with facility physicians
- Ensured all documentation was kept confidential and compliant with HIPAA
Server/ Hostess
Duffy's Sports Grill
02.2013 - 06.2014
- Assisted customer with questions and or concerns both in person and over the phone, awarded "Best Hostess", established and maintained a group of repeat customers.
- Served as Trainer for new employees
- Greeted and served guests in a friendly manner
- Consistently delivered reliable and enthusiastic customer service
Facility Manager
Hawk Ridge Farms
04.2011 - 02.2013
- Successfully operated and managed a Dressage Equestrian facility, ensured property owners' needs were met as well as the clientele who frequented the establishment.
- Responsible for the efficient operation of the facility
- Created training schedule for clientele
- Scheduled veterinarian and Farrier appointments
- Ensured the facility was properly maintained
Education
Diploma -
Wellington High School
Wellington, FL01.2012
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Palm Beach State College
Lake Worth, FL01.2014
Skills
- Prior authorization process
- Medical terminology
- ICD 10 code experience
- Insurance verification
- worked in multiple EHR systems including RainTree, NextGen, AdvancedMD
- Worked in Microsoft Teams and Sharepoint
Timeline
Prior Authorization Specialist (Medix Contract)
Ivy Rehab
11.2025 - 11.2025
Patient Experience Coordinator
Athletico Physical Therapy
11.2018 - 08.2025
Receptionist
Center for Bone and Joint Surgery
05.2016 - 10.2018
Patient Access Representative
Delray Medical Center
05.2015 - 03.2016
Server/ Hostess
Duffy's Sports Grill
02.2013 - 06.2014
Facility Manager
Hawk Ridge Farms
04.2011 - 02.2013
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Palm Beach State College
Diploma -
Wellington High School