Amanda Reyes
Orlando/Ocala,FL
Summary
Healthcare operations and revenue cycle professional with experience supporting insurance authorizations, claim denials, patient access, referral coordination and specialty pharmacy case management. Skilled in navigating multi-payer authorization platforms, coordinating cross-functional care workflows, and resolving insurance-related barriers. Experienced in high-volume patient care operations while maintaining accuracy, efficiency and communication.
Overview
1
1
Certification
3
3
years of professional experience
Work History
CASE MANAGER
AssistRx
2025.11 - 2026.09
- Manage prior authorizations, benefits verification, and prescription processing for specialty medications.
- Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of prescription triage.
- Coordinate with providers, payers, pharmacies, and patients to resolve claim issues, claim denials, missing documentation or delays medication access.
- Support high-volume case management workflows while maintaining accuracy, quality and strong communication.
SENIOR PATIENT CARE COORDINATOR
ChenMed
2025.05 - 2025.11
- Coordinated patient care, referrals, and follow-up appointments for senior patient populations.
- Managed referral workflows, insurance authorizations, specialist scheduling using EPIC and internal EMR systems.
- Managed and coordinated incoming laboratory, diagnostic imaging & specialty consultation results to support provider review and continuity of care.
- Handled high-volume inbound/outbound communication while maintaining strong patient service and documentation.
REFERRAL COORDINATOR LEVEL II
Orlando Health
2023.04 - 2025.05
- Processed pre-certification and prior authorization requests for advanced imaging services including breast biopsy, MRI, MRA, CTA, CT, PET and nuclear medicine.
- Coordinated with providers, radiology departments, and insurance carriers to resolve authorization/claim denials.
- Supported revenue cycle operations through efficient authorization management and denial prevention to optimize workflow.
- Assisted with onboarding and training team members on payer-specific guidelines, authorizations workflows and criteria to streamline consistent efficiency.
Education
Associate of Science -
Valencia College
Orlando, FL09.2026
Skills
- Healthcare Operations
- Revenue Cycle Management
- Case Management
- Prior Authorizations
- Insurance Verification/ Benefits Investigation
- Denial Resolution/Prevention
- Claims Verification/Resolution
- Specialty Pharmacy Coordination
- EPIC/EMR systems
- Payer Portal Management (Availity, Carelon, Evicore, Evolent, United Healthcare)
Certification
CRCR
Timeline
CASE MANAGER
AssistRx
2025.11 - 2026.09
SENIOR PATIENT CARE COORDINATOR
ChenMed
2025.05 - 2025.11
REFERRAL COORDINATOR LEVEL II
Orlando Health
2023.04 - 2025.05
Associate of Science -
Valencia College