Kathryn Dodge

Prior Authorization Specialist @Triarq Health

Royal Oak, MI, US

Optimizes the reimbursement of high cost medications (oral, intramuscular, intravenous, etc) verifying insurance coverage prior to medications being administered or dispensed. • Maintained a 98% approval rate for medical and pharmacy prior authorizations.• Kept up-to-date with the latest prior authorization guidelines and medical/pharmacy policies.• Researched alternative paths to obtain approvals, ensuring efficient processing.• Managed medication ordering from specialty pharmacies.• Claim status and denial follow up; ensuring claims are processed accurately and timely.• Effectively communicated benefits and potential out-of-pocket costs to patients.• Collected outstanding balances from patients and set up payment plans.• Pursued medication and co-pay assistance for uninsured or under-insured individuals.•Managing and supporting offshore team with authorizations questions.

South Lake High School

High School Diploma