Keshonta Carter

Experienced healthcare administrative professional with over 20 years of experience in medical office operations, insurance pre-certification, patient scheduling, and care coordination. Extensive knowledge of insurance benefits, prior authorizations, appeals, medical terminology, ICD-10 and CPT codes. Skilled in managing complex schedules, coordinating multidisciplinary care, resolving insurance issues, and maintaining accurate patient records.

Recognized for strong organizational abilities, problem-solving skills, leadership, and a commitment to exceptional patient service.

Pre-Certification Specialist at Phoebe Putney Memorial Hospital (2023-02 – Present)

Phoebe Radiation Oncology

• Obtain and verify accurate insurance information, coverage, benefits, and eligibility for radiation oncology patients.
• Secure prior authorizations and referrals before radiation therapy appointments to prevent treatment delays.
• Interpret insurance benefits and investigate coverage requirements to ensure appropriate authorization.
• Manage insurance denials and appeals, submitting necessary documentation to obtain authorization approval.
• Review daily patient schedules to identify outstanding authorizations, referrals, and insurance verification needs.
• Collaborate with registration and front desk teams to resolve insurance discrepancies and facilitate patient care.
• Obtain Veterans Affairs (VA) authorizations for referrals, office visits, and radiation therapy services.

Scheduling Coordinator / Team Leader at Phoebe Putney Memorial Hospital (2016-01 – 2023-02)

Phoebe Radiation Oncology

• Coordinated new patient referrals, follow-up appointments, diagnostic imaging, laboratory testing, and external facility services.
• Managed physician schedules and coordinated appointments across departments to ensure continuity of patient care.
• Retrieved medical records and requested diagnostic imaging through Nuance PowerShare.
• Maintained accurate patient information, clinical documentation, and procedure records within MOSAIQ.
• Assisted physicians during examinations and managed documentation and professional fee charges for laryngoscopy procedures.
• Coordinated insurance authorizations, referrals, peer-to-peer reviews, and submission of clinical documentation.
• Assisted with VA and TRICARE authorizations and other insurance pre-certification requirements.
• Served as team leader, overseeing staff scheduling, approving time-off requests, and performing managerial functions within API.
• Supported workflow improvements and promoted efficient scheduling and authorization processes.
• Maintained working knowledge of radiation oncology procedures, medical terminology, ICD-10 codes, and CPT codes.

Office Coordinator at Phoebe Putney Memorial Hospital (2015-08 – 2016-01)

Phoebe Cancer Center – Stem Cell Department

• Coordinated bone marrow biopsies, survivorship visits, sick clinic appointments, referrals, and staff meetings.
• Managed medical and office supply inventory to support daily departmental operations.
• Processed professional fees, departmental charges, and patient documentation using MOSAIQ.
• Followed up on VA authorizations and insurance pre-certification requirements.
• Managed telephone communications, incoming faxes, medical records, and patient scheduling.
• Supported nursing staff, patients, and families with administrative and patient service needs.
• Assisted the Lung Navigator with patient documentation, lung screening records, and correspondence.
• Maintained records and entered charges for stem cell, apheresis, bone marrow, and PICC services.
• Assisted with special projects and administrative initiatives.

Medical Center Representative at Phoebe Putney Memorial Hospital (2004-06 – 2015-08)

Phoebe Cancer Center

• Managed patient check-in, registration coordination, referrals, and physician appointment scheduling.
• Scheduled diagnostic procedures, rescheduled missed appointments, and coordinated inpatient consultations.
• Answered multiline telephone systems and facilitated communication between patients, physicians, and clinical staff.
• Supported on-call physicians and coordinated after-hours communication.
• Assisted with specimen collection for laboratory pickup and maintained office supply inventory.
• Provided professional, compassionate assistance to patients and families.

High School Diploma – Westover High School (2002)