Amanda Mendoza
DeLand,FL
Summary
Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
16
16
years of professional experience
Work History
Patient Access Representative
Kroger Specialty Pharmacy
Lake Mary, FL
07.2023 - Current
- Verified insurance coverage for services provided by the facility.
- Maintained confidentiality of all patient information in accordance with HIPAA regulations.
- Answered phones promptly in a professional manner.
- Actively participated in team meetings and training sessions.
- Applied HIPAA privacy and security regulations while handling patient information.
- Verified demographics and insurance information to register patients in computer system.
- Collaborated with clinical and administrative staff to meet patient needs.
- Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
Scheduler
True Health
Sanford, FL
04.2023 - 07.2024
- Answered phones and routed voicemails to respective employees.
- Assisted organizational efforts by filing, entering data and answering phones.
- Maintained positive working relationship with fellow staff and management.
- Processed incoming referrals for new patients, verifying insurance information and scheduling appointments accordingly.
- Verified insurance eligibility for each patient prior to their appointment date.
- Assisted patients with canceling and rescheduling appointments.
Patient Service Representative
Children's Home Medical Equipment
Orlando, FL
10.2020 - 03.2021
- Provided customer service by answering patient questions and addressing concerns.
- Verified insurance information, collected payments, and scheduled appointments.
- Maintained a clean and organized reception area.
- Answered incoming calls in a professional manner.
- Processed referrals from primary care physicians to specialists for further treatment or evaluation.
- Performed administrative duties such as filing, faxing, photocopying.
- Assisted with scheduling follow-up appointments according to provider availability.
- Adhered to HIPAA regulations when handling confidential patient information.
- Provided support with various tasks such as scheduling tests, ordering supplies.
Precertification Specialist
Aetna SpecialtyPharmacy
Orlando, FL
12.2008 - 12.2019
- Reviewed patient medical records to determine medical necessity for requested services and procedures.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Compiled and submitted precertification requests for review by payers in accordance with established timelines.
- Provided follow-up on pending precertification requests to ensure timely processing.
- Maintained detailed documentation of all activities related to the precertification process.
- Assisted with answering provider inquiries regarding preauthorization requirements and processes.
- Collaborated with other departments within the organization as needed to resolve issues or obtain additional information.
- Ensured compliance with all HIPAA regulations pertaining to protected health information.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Participated in new hire training and development tasks.
- Managed intake of new claims and performed routine follow-ups.
- Communicated with patients with compassion while keeping medical information private.
Education
High School Diploma -
Pine Ridge High School
Deltona, FL03-2000
Skills
- HIPAA Compliance
- Insurance Verification
- Quality Assurance
- Registration management
- Multitasking and Organization
- Customer Service
- Appointment Scheduling
- Insurance company knowledgeable
- Team Leadership
- Relationship Building
- Phone and Email Etiquette
Languages
Spanish
Professional
References
References available upon request.
Timeline
Patient Access Representative
Kroger Specialty Pharmacy
07.2023 - Current
Scheduler
True Health
04.2023 - 07.2024
Patient Service Representative
Children's Home Medical Equipment
10.2020 - 03.2021
Precertification Specialist
Aetna SpecialtyPharmacy
12.2008 - 12.2019
High School Diploma -
Pine Ridge High School