Adrianna Hererra
Las Vegas
Summary
Medical representative with 6 years of experience excelling in customer service, billing, and administrative tasks. Demonstrates exceptional organizational skills, adaptability, and empathy in diverse medical environments. Seeking a role that values dedication, offers growth opportunities, and fosters a professional atmosphere.
Detail-oriented prior authorization specialist proudly offering several years' experience managing medical documents meticulously. Polished professional known for working closely with insurance companies to alleviate denied claims and obtain necessary prior approvals for services. Multitasks expertly in fast-paced environments.
Overview
8
8
years of professional experience
4045
4045
years of post-secondary education
Work History
Billing /Prior Authorization Specialist
WHASN Meadows
Las Vegas
10.2022 - Current
- Verify insurance benefits and eligibility, handle copays, Referral status for office visits, and obtain prior authorizations for procedures.
- Handle payment plans for balances
- Review and adjust payments on claims, discuss EOBs with patients, and set up payment plans as needed.
- Facilitate claim payments to patients, ensuring clarity on balances
- Collect insurance information as needed
- Process prior authorization requests for various medical procedures and services.
- Communicate with insurance companies regarding authorization approvals and denials.
- Maintain accurate records of authorization requests in electronic systems.
- Educate patients on the prior authorization process and requirements.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Trained new staff on prior authorization procedures and company policies.
Medical receptionist
Strimling Dermatology Laser and Vein
Las Vegas
07.2021 - 10.2022
- Answering high call volume, greeting and checking in our customers and animals.
- Receive incoming prescription requests.
- Scheduling appointments & following up to confirm appointments.
- Assist with animals if needed and data entry for files.
- Handled phone calls, directing inquiries to appropriate departments promptly.
- Checked patients in and out for appointments and collected co-payments.
- Verified insurance information and collected co-pays at front desk.
- Assisted patients with inquiries about treatments and procedures.
Receptionist
Cheyenne Tonopah Animal Hospital
Las Vegas
02.2018 - 07.2021
- Managed front desk operations and greeted clients with professionalism.
- Scheduled appointments and maintained accurate records for patient visits.
- Answered phone calls and provided information about services offered.
- Coordinated communication between veterinarians and pet owners effectively.
- Answered incoming calls, took messages, and transferred calls to appropriate departments or personnel.
- Maintained daily calendars, set appointments with clients and planned daily office events.
- Managed all incoming mail distribution, courier services, faxes, and photocopying documents as requested.
- Processed payments and updated accounts to reflect balance changes.
Education
High School Diploma -
Centennial High School
Las vegasCollege of Southern Nevada
Skills
- Data Entry
- Detail-orientation
- Customer Service
- Multi-tasking
- Organization
- Written Communication
- Verbal Communication
- Teamwork
- Billing
- Time Management
- Empathy
- Adaptability
- Dependable
- Payment Processing
- File Management
- Administrative Support
- Payment Collection
- Medical coding
- CPT coding
- ICD-10 coding
Timeline
Billing /Prior Authorization Specialist
WHASN Meadows
10.2022 - Current
Medical receptionist
Strimling Dermatology Laser and Vein
07.2021 - 10.2022
Receptionist
Cheyenne Tonopah Animal Hospital
02.2018 - 07.2021
High School Diploma -
Centennial High School
College of Southern Nevada