ALVARO CAMARENA

• Performs Medical Assistant, Prior Authorization Specialist, Registration Check in and Patient Call Representative daily task.
• Follows established Back Office clinic protocols, EKGS and Heart Monitors.
• Obtains high volume of prior authorization request for diagnostic services and procedures (Echo, Echo Stress, ZIO monitors, Nuclear Medicine exams, CTA’s, Left and Right Heart catheterization, Device implantable (ex; Pacemakers, Defibrillators, Loop Recorders) and other cardiac procedures to be done in hospital setting.
• Schedules procedures for patients and provides necessary preparatory instructions before scheduled procedure/surgery.
• Interfaced with medical and pharmaceutical vendors to gather and relay information to physicians to reduce none-value added time/work
• Backup Manager, with proven ability to work alone, or with team.
• Processing 91 and 31 day remote reports clinic billing for Pacemakers, defibrillator, and implantable loop recorders.
• Facilitated communication between medical staff members to maintain cohesive team focused on providing exceptional patient care.
• Implemented new processes for managing patient flow, minimizing wait times while maintaining high-quality care standards throughout practice.
• Utilized data analysis techniques to identify areas for improvement within practice, implementing targeted changes to drive positive outcomes for both patients and staff members.
• Identified opportunities to streamline processes and improve office operations and efficiency.

• Performs Medical Assistant, Prior Authorization Specialist, Registration Check in and Patient Call Representative daily task.
• Managed Cardiology, Rheumatology, ENT, Pulmonology,
  Gastroenterology, Orthopedic Surgery, OBGYN, Urology, Dermatology, Ophthalmology and Optometry.

Maintains competency in obtaining and inputting medical information to and from clinical and /or other information systems including accessing information as required to complete referral process.

• Prepares and provides multiple, complex details to insurance or worker's compensation carrier to obtain prior authorizations for both standard and complex requests such as imaging, non-invasive procedures, sleep studies etc.
• Communicates medical information to insurance carrier, and coordinates peer-to-peer reviews for denied services.
• Manages large amounts of inbound and outbound calls in timely manner.
• Follows communication “scripts” when handling different topics.
• Identifies patient’s needs, clarifies information, research every issue and provide solutions and/or alternatives.
• Completed EKGs and other tests based on patient presentation in office.
• Completely registers patient into EPIC/APEX charts by acquiring demographics, insurance information and registration documents
• Explained procedures to patients to reduce anxieties and increase patient cooperation.
• Oriented and trained new staff on proper procedures and policies.
• Updated inventory, expiration and vaccine logs to maintain current tracking documentation.
• Conducted monthly and quarterly inventory of supplies using facility cost reporting records.
• Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
• Streamlined authorization processes by implementing centralized tracking system for pending and approved requests.
• Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
• Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
• Maintained up-to-date knowledge of insurance policies, enabling accurate evaluation of coverage eligibility criteria for patients.
• Conducted thorough reviews of medical records to identify and address potential issues affecting authorization approvals.
• Decreased processing time for authorizations by establishing strong relationships with insurance representatives and case managers.
• Developed comprehensive training materials for new Authorization Coordinators, contributing to their successful onboarding process.
• Stayed informed about regulatory changes relevant to healthcare industry, ensuring compliance in all authorization activities.
• Optimized workflows within department by identifying areas of improvement and proposing actionable solutions.
• Assisted with financial counseling for uninsured or underinsured patients, connecting them with resources for affordable care options when necessary.
• Coordinated seamless transitions of care for patients requiring referrals to specialty services, facilitating smooth handoffs between providers.
• Participated in regular audits of authorization files, addressing discrepancies and implementing corrective actions as needed.
• Contributed to development of departmental policies and procedures relating to authorization management, promoting standardization across teams.
• Mastered multiple software systems for seamless navigation during calls, improving efficiency and reducing hold times for customers.
• Developed rapport with customers through empathetic listening skills, creating positive experiences even during difficult conversations.
• Mentored new hires as they navigated our systems and protocols, fostering teamwork within call center.
• Sought out extra training opportunities to enhance customer relationship management abilities.
• Cross-trained and backed up other customer service managers.
• Increased efficiency and performance by monitoring team member productivity and providing feedback.
• Trained staff on operating procedures and company services.
• Cross-trained and provided backup support for organizational leadership.

• Performs Medical Assistant, Prior Authorization Specialist, Registration Check in and Patient Call Representative daily task.
• Interfaced with medical and pharmaceutical vendors to gather and relay information to physicians to reduce none-value added time/work.
• Creates schedules for department staff.
• Liaised with patients and addressed inquiries, appointment requests and billing questions.
• Collected pertinent data and calculations to aid physician in interpreting results.
• Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
• Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.

• Registers follow up appointments and confirms appointments for efficient office workflow.
• Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
• Improved appointment scheduling system, reducing wait times and increasing client satisfaction.
• Assisted in planning of office events and meetings, ensuring smooth execution and positive outcomes.
• Contributed to team success by cross-training in various administrative roles, providing backup support when necessary.
• Assists patients in obtaining medical records and completing necessary release forms.
• Inputs internal/external referrals to increase patient volume to office.
• Manages cash, check and credit/debit cards for deductible or copayments due.
• Maintains accurate electronic and paper medical records for patient care, condition, progress and concerns.
• Registers vital signs, such as blood pressure and pulse to help with consultation workflow.
• Obtains patient's medical history, medication history, and procedure histories for efficient consultation.
• Maintains clean and safe environment for patients.
• Performs clerical duties, such as word processing, data entry, and answering high volume of calls.
• Performs minor procedures and uses equipment as delegated by licensed professional.
• Provides subcutaneous injection training to patients in order for them to administer self-injectable medications properly.
• Collects Specimens from joint aspirations and prepares specimen to send out for cell count or culture.
• Submits, track and obtain prior authorization for medications, IV medication, referrals and procedures ordered by physicians.
• Complies with and adheres to all regulatory compliance areas, policies and procedures.
• Protect patients’ personal information and abide by HIPAA regulations.
• Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information.