EMMANUEL SENOR
Pompano Beach,FL
Summary
Experienced in healthcare operations, including medical records retrieval, DME coordination, insurance benefits verification, and auditing in recovery treatment environments. Bring a comprehensive skill set and a strong commitment to patient confidentiality and compliance. Collaborated closely with clinical, administrative, and billing teams to ensure accurate documentation, timely insurance processing, and seamless care coordination. Prioritized efficient communication with providers and patients while safeguarding PHI in accordance with HIPAA and 42 CFR Part 2 standards. Earned a reputation for precision and attention to detail as a Medical Records and Request Auditor, helping facilities remain audit-ready and compliant with state and federal regulations. Hands-on experience with insurance verification has equipped me to navigate payer systems, confirm behavioral health benefits, and secure authorizations to support timely admissions. Well-versed in DME equipment logistics, assisting patients with essential tools while upholding quality service and documentation standards. Confident that my broad administrative experience and dedication to quality care make me a strong candidate for this role. Welcome the opportunity to discuss how my background aligns with your team’s needs and contributes to your mission of delivering exceptional healthcare services.
Overview
10
10
years of professional experience
Work History
Patient Medical Records Request Auditor
Zinnia Health and Wellness Center
Delray Beach, FL
09.2024 - Current
- Review and audit all patient medical record requests prior to release, ensuring they are complete, accurate, and compliant with HIPAA and applicable privacy laws.
- Verify legal authorization forms to confirm proper consent is on file for each request.
- Ensure that only the minimum necessary information is disclosed, based on the scope of each request.
- Track and log all incoming and outgoing requests using internal systems to maintain full audit trails.
- Communicate with patients, legal representatives, and third-party requestors (e.g., insurance companies, attorneys) to clarify or resolve issues related to medical record access.
- Identify and flag any discrepancies, missing documentation, or potential privacy risks.
- Work closely with medical records and compliance teams to correct issues and ensure records are properly processed.
- Assist in training staff on release of information (ROI) protocols and regulatory changes.
Medical Records Auditor
Banyan Treatment Center / New Leaf Billing
Pompano Beach, Florida
05.2021 - 08.2024
- Conduct regular audits of patient medical records for accuracy, completeness, and compliance with clinical, regulatory, and billing standards.
- Review documentation to ensure services are medically necessary, appropriately documented, and aligned with level-of-care requirements (e.g., residential, PHP, IOP).
- Identify documentation gaps, inconsistencies, or risks and provide clear feedback to clinicians and administrative staff.
- Track audit results and create reports for leadership, recommending corrective action plans when necessary.
- Work collaboratively with clinical, billing, and compliance teams to ensure timely and accurate recordkeeping.
- Stay up to date on federal and state regulations, payer requirements, and best practices in behavioral health documentation.
- Assist in preparing for external audits or accreditation reviews (e.g., Joint Commission, insurance audits).
- Educate staff on proper documentation protocols and contribute to quality improvement initiatives.
Insurance Benefits Verification Specialist
Banyan Treatment Center
Pompano Beach, Florida
08.2019 - 04.2021
- Verify insurance benefits for substance abuse, mental health, and co-occurring disorder treatment services.
- Obtain prior authorizations, pre-certifications, and referrals as required by insurance providers.
- Communicate directly with insurance carriers to confirm coverage details, including deductible, co-pay, coinsurance, and out-of-pocket maximums.
- Coordinate with admissions staff to provide patients with accurate financial responsibility information prior to intake.
- Input and update insurance and authorization information accurately in the EMR system.
- Maintain current knowledge of payer policies related to behavioral health and residential/inpatient treatment.
- Assist with appeals and denials, providing documentation and follow-up support as needed.
- Work closely with clinical, billing, and case management teams to ensure seamless patient admission and treatment continuation.
DME Medical Equipment Technician
A. B. Direct Marketing Inc
Boca Raton, FL
07.2017 - 05.2019
- Answer inbound calls and respond to inquiries related to medical equipment orders, deliveries, and billing.
- Coordinate DME orders from intake through delivery, ensuring all required documentation (prescriptions, authorizations, insurance) is complete.
- Verify insurance coverage and obtain prior authorizations as needed.
- Communicate with patients, caregivers, and medical professionals to clarify equipment needs and eligibility.
- Resolve issues related to delayed orders, equipment malfunctions, or insurance denials.
- Maintain accurate records in internal systems (e.g., EMR, billing software).
- Ensure compliance with HIPAA and DME regulatory standards.
- Support billing and collections teams with claims-related information as required.
Medical Records Retrieval Specialists
Rapid Relief Medical (DME)
Delray Beach, FL
10.2015 - 05.2017
- Contact hospitals, clinics, and physician offices to request and retrieve medical records on behalf of clients.
- Follow up regularly with providers via phone, fax, email, and/or secure portals.
- Track and document communication attempts and status updates in internal systems.
- Review received medical records for completeness and accuracy.
- Ensure all medical records are handled in accordance with HIPAA and other regulatory standards.
- Resolve delays and escalate issues as needed to meet deadlines.
- Communicate effectively with clients or internal teams regarding status and issues.
- Maintain accurate logs and reports for auditing and tracking purposes.
Education
Certificate of Completion: Barbering -
Florida Barber Academy
06.2013
High School Diploma -
Boca Raton High School
06.2000
Skills
Attention to detail
Team collaboration
Audit reporting
Decision-making
Clear communication
Compliance standards
Multitasking and organization
Time management
Critical thinking
Microsoft office, Word, Excel Spreadsheet
Critical thinking and analysis
Records maintenance
Audit support
Data collection
Records review
Workload management
Timeline
Patient Medical Records Request Auditor
Zinnia Health and Wellness Center
09.2024 - Current
Medical Records Auditor
Banyan Treatment Center / New Leaf Billing
05.2021 - 08.2024
Insurance Benefits Verification Specialist
Banyan Treatment Center
08.2019 - 04.2021
DME Medical Equipment Technician
A. B. Direct Marketing Inc
07.2017 - 05.2019
Medical Records Retrieval Specialists
Rapid Relief Medical (DME)
10.2015 - 05.2017
Certificate of Completion: Barbering -
Florida Barber Academy
High School Diploma -
Boca Raton High School