Summary
Overview
Work History
Education
Skills
Timeline
Generic

ALESSANDRA CRUZ

Tamarac,FL

Summary

To secure a position where I can provide my medical office skills and insurance experience to a company, while pursing professional growth. Detail-oriented worker with knowledge of account management and collaborating with other departments. Talented at data entry and analysis with exceptional knowledge of Medical clinical knowledge. Cooperative Correspondence Clerk with 15 years of experience. Adept at customer service and staying client focused through conflict resolution. Exceptional customer service skills and accurate typing ability. Systematic Correspondence Clerk with 20 years of experience. Skilled at [eclinicals and ram soft use with exceptional knowledge of manage. Successful at filling customer requests and quick and accurate document preparation. Experienced benefits and auth specialist with over 20 years of experience in Medical administration. Excellent reputation for resolving problems and improving customer satisfaction. Reliable employee seeking a problem solver position. Offering excellent communication and good judgment. To seek and maintain a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Dedicated professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Friendly student available for weekend, evening and holiday shifts. Considered hardworking, punctual and driven. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Productive member brings experience in heavy equipment operation and construction site preparation. Talents include ground excavation, leveling and grading to precise specifications. Equipped with thorough command of safety protocols and hazard management. Enthusiastic to make sure patients get the care of they are entitled eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of role and training in insurance. Motivated to learn, grow and excel.. Reliable Intern studying seeks an internship opportunity to expand skills and gain valuable real-world experience. Hardworking and passionate job seeker with strong organizational skills eager to secure a long term employment.

Overview

12
12
years of professional experience

Work History

Authorization Coordinator

IMPRESSION IMAGING
TAMARAC, FL
01.2020 - 11.2022
  • Reviewed documentation for accuracy and assessment of necessity.
  • Calculated estimated copay based on current insurance benefits.
  • Submitted for prior authorization with required documentation to appropriate funding source.
  • Maintained consistent follow-up on status of prior authorization requests.
  • Reviewed authorizations from payer to determine approved or denied items.
  • Presented clear and concise explanations of governing rules and regulations.
  • Computed costs of records furnished to requesters and wrote letters to obtain payment.
  • Prepared documents and correspondence such as damage claims, credit and billing inquiries and service complaints.
  • Gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
  • Communicated with executives about consistent customer issues.
  • Edited letters and written material for correspondence.
  • Completed form letters in response to requests or problems identified by correspondence.
  • Maintained files and controlled records to show correspondence activities.
  • Read incoming correspondence to ascertain nature of writers' concerns and to determine disposition of correspondence.
  • Typed acknowledgment letters to persons sending correspondence.
  • Used Microsoft Word and other software tools to create documents and other communications.
  • Successfully maintain clean, valid driver's license and access to reliable transportation.
  • Handled [Number] calls per day to address customer inquiries and concerns.
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
  • Participated in team-building activities to enhance working relationships.

Referral Coordinator

Healthy Partners
Hallandale Beach, FL
04.2017 - 06.2018
  • Processed 40-60 Referrals for Humana Gold Plus
  • Handled Circle of care and kept Star rating of 5 stars
  • Handled and took care of patient care coordination from setting appointments to retrieving all medical records.
  • Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
  • Followed up with clients and specialists to inquire about experience and collect reports.
  • Coordinated with medical staff and patients to find cost-effective options for services.
  • Called insurance companies to get precertification and other benefits information on behalf of patients.

Referral Coordinator

Cardiovascular Specialists
Davie, FL
02.2010 - 05.2013
  • Responsible for obtaining authorization for all diagnostic testing done in office
  • Verified all insurance for consults and diagnostic testing in office
  • Scheduled and confirmed all patients
  • Supervised and trained all front desk personnel to check in/out patients
  • Assisted doctor's with credentialing for all insurance companies.
  • Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
  • Weighed patient need, provider availability and insurance coverage to determine optimal scheduling.
  • Followed up with clients and specialists to inquire about experience and collect reports.
  • Coordinated with medical staff and patients to find cost-effective options for services.
  • Called insurance companies to get precertification and other benefits information on behalf of patients.

Referral Coordinator

Primary Care Physicians
Hollywood, FL
02.2009 - 05.2011
  • Responsible for obtaining authorization and schedule for all specialist consults and diagnostic testing
  • Provided all clinicals necessary for obtaining authorization for all testing
  • Scheduled and confirmed all patients
  • Supervised and trained all front desk personnel to check in/out patients
  • Assisted doctor's with credentialing for all insurance companies
  • Processed all medical records.

Scheduler/Front Desk

Pines Radiology Center
Pembroke Pines, FL
12.2006 - 02.2009
  • Scheduled all testing for MRI, CT, Ultrasounds, Mammograms, X-ray testing
  • Processed scheduled patients from verifying insurance to walking and assigning patients to correct technician
  • Provided patients with correct preparation for their scheduled exams
  • Confirmed patients daily for the appointments the following day.

Education

High School Diploma -

North Bergen High School
1997

Skills

  • Prior Authorization
  • Customer inquiries
  • Payment collection
  • Digital filing
  • Written Communication
  • Planning and Coordination
  • Decision Making
  • Teambuilding
  • Training and Development
  • Problem-Solving
  • Clerical Support
  • Flexible and Adaptable
  • Multitasking Abilities
  • Self-Motivated
  • Teamwork and Collaboration

Timeline

Authorization Coordinator

IMPRESSION IMAGING
01.2020 - 11.2022

Referral Coordinator

Healthy Partners
04.2017 - 06.2018

Referral Coordinator

Cardiovascular Specialists
02.2010 - 05.2013

Referral Coordinator

Primary Care Physicians
02.2009 - 05.2011

Scheduler/Front Desk

Pines Radiology Center
12.2006 - 02.2009

High School Diploma -

North Bergen High School
ALESSANDRA CRUZ