Marissa Smith
Cartersville
Summary
Detail-oriented Prior Authorization and Insurance Verification Specialist with over five years of experience in surgical scheduling, orthopedic authorizations, and advanced imaging. Expertise includes high-volume eligibility verification, complex benefit interpretation, denial prevention, and effective payer communication. Demonstrated ability to manage multiple cases simultaneously while enhancing workflow efficiency. Eager to leverage skills in ABA-specific prior authorization workflows and contribute to innovative process automation initiatives.
Overview
7
7
years of professional experience
Work History
Insurance Authorization Specialist – Orthopedics
WellStar Health Systems
Atlanta, GA
11.2021 - Current
- Manage high-volume prior authorizations for adult and pediatric orthopedic procedures and advanced imaging.
- Verify insurance eligibility, benefits, deductibles, exclusions, and financial responsibility.
- Submit detailed clinical documentation via payer portals and direct insurer outreach.
- Track and follow up on pending authorizations to prevent delays or cancellations.
- Review denials and initiate appeals in accordance with payer guidelines.
- Collaborate with physicians, billing teams, and schedulers to streamline authorization workflows.
- Identify opportunities to improve turnaround time and reduce approval delays.
Surgery & Diagnostic Scheduler
Pediatric Orthopedic Associates
Atlanta, GA
01.2019 - 01.2021
- Scheduled surgical and diagnostic procedures while ensuring insurance compliance.
- Obtained prior authorizations and verified benefits for all scheduled cases.
- Discussed financial responsibilities with patients to ensure transparency.
- Managed physician OR schedules and coordinated pre- and post-operative care.
- Maintained confidential medical records in compliance with HIPAA standards.
Education
Associate of Arts Degree -
Georgia Highlands College
Rome, GA01.2017
Skills
- Epic, Athenahealth, and SRS proficiency
- Experience with major insurance portals
- Experienced with Microsoft Office applications
- Efficient phone communication skills
Timeline
Insurance Authorization Specialist – Orthopedics
WellStar Health Systems
11.2021 - Current
Surgery & Diagnostic Scheduler
Pediatric Orthopedic Associates
01.2019 - 01.2021
Associate of Arts Degree -
Georgia Highlands College
Core Competencies
- Prior Authorizations (Services & Procedures)
- Insurance Eligibility & Benefits Verification
- Deductibles, Co-Insurance & Out-of-Pocket Calculations
- Denial Management & Appeals
- Multi-Payer Insurance Knowledge (Commercial, Medicare, Medicaid)
- Surgical & Diagnostic Scheduling
- Process Improvement & Workflow Optimization
- Patient Financial Counseling
- HIPAA Compliance