Alyssa Gonzales
DeMotte,IN
Summary
Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows. Dedicated to offering exceptional assistance to team members and clients. Skilled at coordinating appointments, organizing mail and collecting messages to facilitate office communication. Positive and upbeat with strong relationship-building abilities.
Overview
9
9
years of professional experience
Work History
Sleep Reception & Prior Authorization Specialist
Neurological Institute And Specialty Centers
2023.06 - Current
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Kept reception area clean and neat to give visitors positive first impression.
- Answered phone promptly and directed incoming calls to correct offices.
- Responded to inquiries from callers seeking information.
- Resolved customer problems and complaints.
- Corresponded with clients through email, telephone, or postal mail.
- Handled cash transactions and maintained sales and payments records accurately.
- Managed multiple tasks and met time-sensitive deadlines.
- Maintained confidentiality of information regarding clients and company.
Lead Optician
Moses Eyecare Centers
2021.07 - 2023.06
- Educated patients on proper use, care and maintenance of eyeglasses and contact lenses.
- Calibrated seg heights, vertex, and pupillary distance and pantoscopic tilt to customize eyeglass orders and create perfect fit.
- Filed claims with vision and medical insurance companies to garner payment for optical services.
- Maintained safe, clean and organized environment to increase patient comfort.
- Confirmed quality control standards were met for all eyewear and contact lenses.
- Contacted patients when eyeglasses or contact lenses arrived in store and assisted with final fitting.
- Verified and updated patient records promptly to guarantee accurate prescription information.
- Aided patients in selection of flattering eyeglass frames appropriate for prescription and style preferences.
- Measured patients' faces for bridge, eye size, and temple length to select comfortable frames.
- Educated clients about how to adapt to, wear, and care for eyeglasses.
- Helped clients try on and select new frames and recommended lens options to meet specific needs.
- Discussed optimal lens, coating, and frame recommendations with customers to meet individual needs.
Assistant Manager
McDonald's
2019.09 - 2020.05
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
- Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Mentored team members to enhance professional development and accountability in workplace.
- Generated repeat business through exceptional customer service and responded to customer concerns with friendly and knowledgeable service.
- Helped with planning schedules and delegating assignments to meet coverage and service demands.
- Developed loyal and highly satisfied customer base through proactive management of team customer service strategies.
- Created employee schedules to align coverage with forecasted demands.
- Developed strategy to increase sales and drive profits.
- Reviewed sales and gross profit report to assess company efficiency.
- Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
Assistant Manager
Casey's General Stores Inc
2014.12 - 2018.05
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
- Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Mentored team members to enhance professional development and accountability in workplace.
- Created employee schedules to align coverage with forecasted demands.
- Reviewed sales and gross profit report to assess company efficiency.
- Strengthened merchandising and promotional strategies to drive customer engagement and boost sales.
- Made hiring recommendations to increase company's productivity and profitability with quality workers.
- Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.
- Established team priorities, maintained schedules and monitored performance.
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
Education
High School Diploma -
Lowell Senior High School
Lowell, IN06.2015
Skills
- Insurance Procedures
- Knowledgeable in [Software]
- Retro-Authorizations
- Claim Research
- Effective Communication Skills
- Authorizations
- Benefit Coverage
- Data Entry
- Understanding of Insurance Details
- Patient Referrals
- Understanding of Medical Terms
- Physician Order Verification
- Records Maintenance
- Scheduling
- Strategic Planning
- Customer/Client Relations
- Time Management
- Customer and Client Relations
- Staff Management
- Performance Improvement
- Schedule Management
- Document Management
- Eyewear Brands
- Order Preparation
- Customer Service
- Optical Orders
- Retail Sales
- Corrective Lens Options
- Transaction Processing
- Eyewear Trends
- Insurance Verification
- Patient History Documentation
- Inventory Management
- Prescription Evaluation
- Supply and Equipment Ordering
- Attention to Detail
- Insurance Approvals
- Fittings
- Frame Repair
- Administrative Functions
- Children's Eyewear
- Verifying Prescriptions
- Selecting Frames
- Appointment Scheduling
- Task Delegation
- Employee Scheduling
- Recruiting and Interviewing
- Product and Service Knowledge
- Money Handling
- Staff Supervision
- Staff Development
- Google Drive
- Orientation and Training
- Cost Control
- Retail Operations
- Patient Scheduling
Timeline
Sleep Reception & Prior Authorization Specialist
Neurological Institute And Specialty Centers
2023.06 - Current
Lead Optician
Moses Eyecare Centers
2021.07 - 2023.06
Assistant Manager
McDonald's
2019.09 - 2020.05
Assistant Manager
Casey's General Stores Inc
2014.12 - 2018.05
High School Diploma -
Lowell Senior High School
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