Andrea Leyba
Albuquerque,NM
Summary
Results-driven Infusion Therapy Authorization Coordinator focused on enhancing authorization efficiency and compliance. Known for effective problem-solving and active listening skills that improve customer satisfaction and streamline processes. Committed to maintaining high standards in patient interactions and facilitating organizational growth.
Overview
24
24
years of professional experience
Work History
Authorization Lead
Christus St. Vincent Medical Center
Santa Fe, New Mexico
08.2025 - Current
- Developed innovative ideas and solutions that improved team productivity and outcomes.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
- Resolved customer problems with knowledgeable and friendly service, enhancing satisfaction.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Infusion Therapy Authorization Coordinator
CHRISTUS St. Vincent
Santa Fe, NM
03.2024 - Current
- Reviewed and approved authorization requests according to established criteria.
- Developed strategies that streamlined authorization process, enhancing overall efficiency.
- Ensured compliance with regulations governing authorization processes through ongoing monitoring and assessment.
- Coordinated workflow processes for authorization requests, facilitating document routing and progress tracking.
- Processed incoming authorization requests and updated customer accounts accordingly.
- Assisted customers with questions or problems related to their authorization requests.
- Researched information to resolve customer inquiries or issues with authorizations.
- Evaluated current policies and procedures related to authorizing services or products, making changes where appropriate.
- Analyzed data from various sources to ensure accuracy of authorizations.
- Maintained accurate records of all authorizations in the system.
- Updated spreadsheets to maintain accurate records of authorizations.
- Provided guidance and direction on how to complete authorization forms correctly.
- Collaborated with other departments within the organization to ensure timely completion of authorizations.
- Composed letters and electronic correspondence for professionals and management team.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
Patient Care Coordinator
Christus St. Vincent
Santa Fe, NM
02.2016 - Current
- Coordinated physicians' schedules, managed communications, scheduled surgeries, and followed up on tests and referrals, enhancing patient flow.
- Served as the primary contact in my department for all patient inquiries, including clinical, administrative, and financial questions.
- Collaborated with insurance companies to secure pre-authorizations for surgical procedures, injections, and diagnostic studies, ensuring uninterrupted patient care.
- I Authorize all appointments for workman compensation patients for evaluation and treatment, diagnostic imaging, durable medical equipment, physical therapy, outgoing referrals, and surgery.
- Appealed denied authorizations to secure necessary approvals for patient care.
- I obtain preauthorizations for surgery, steroid injections to post-operative care and medications.
- Keep close contact with adjusters and patients, document detailed communication in regards to patients' workman comp claim.
- Cultivated strong working relationships with physicians and co-workers, fostering a collaborative environment that supports patient care.
- Performed all tasks necessary to increase physician efficiency and improve patient experience.
- Provided patients with detailed billing and financial information to clarify charges.
- I provided detailed billing information to patients to ensure clarity before procedures.
- I do research in the Epic system to figure out what the patients out of pocket expense would be and provide each provider charges for procedures.
- Medicare has a very strict criteria, I would review notes to make sure we were in compliance for a smooth billing process and to make sure all procedures were medically necessary.
- Orthopedic and Sports Medicine, Patient Care Coordinator
Medical Records
Professional Home Health Care
Las Vegas, NM
03.2015 - 02.2016
- Led Medical Records Department at Professional Home Health Care, ensuring compliance with regulatory standards.
- Assembled and audited health records for admissions and discharges, maintaining accuracy and adherence to PHHC chart order.
- Reviewed medical records for compliance with hospital policies and procedures.
- Reviewed medical records for accuracy, completeness, and compliance with regulations.
- Assessed patient response to interventions, documenting accurately in medical records.
Caregiver
Veterans Administration
11.2013 - 02.2016
- Provided direct care to patients in a healthcare setting.
- Facilitated medication compliance and supported patients in performing activities of daily living.
- Provided emotional support and active listening to patients, fostering a trusting and supportive relationship.
- Encourage and schedule outings and social interactions.
- Coordinated transportation to appointments and participated in group therapy and education classes with patients.
- Many veterans have many behavioral health issues and don't always need to be told what to do or how it needs to be done but simply to just listen.
Back up Supervisor
NMBHI at Las Vegas
Las Vegas, NM
08.2006 - 10.2013
- Supervised 12 employees within HIMD during the absence of the HIMD Director and HIMD Associate Director.
- Managed employee time records to ensure accurate payroll.
- Ensured accurate employee clock-ins and added sick, annual, or medical leave as required.
- Entered employee time data into Kronos software.
- Approved and denied leave requests, answered employee questions, and provided training.
- Entered employee leave requests into Kronos from completed forms.
- Managed inventory and ordered charts and office supplies within budget constraints.
HIMD Back up Coder
NMBHI at Las Vegas
Las Vegas, NM
08.2006 - 10.2013
- Assisting coder in coding function at NMBHI.
- Coding admission and discharge diagnosis using ICD-9CM and entering codes into the AVATAR and AS 400 computer systems.
- Coded billing lab slips and physician encounter charge slips according to coding rules and regulations.
- Executed data entry into AS400 software system for coding billing, ensuring compliance with NMDOH regulations and code accuracy.
- Ensured accuracy of codes for medical necessity through thorough verification processes.
- Reviewed documentation to ensure compliance with billing criteria
Release of Information (ROI) Specialist
NMBHI at Las Vegas
Las Vegas, NM
05.2005 - 10.2013
- Ran the Release of Information (ROI) section within HIMD.
- Retrieved and checked out discharged records to the admissions department, copied health records to fulfill requests, and received requests via mail, fax, or phone while ensuring compliance with DOH HIPAA policies and procedures.
- Received and sent out mail and faxes, completed discharge/referral packets and follow-ups, assembled and located health records, stamped and logged all incoming requests to support release of information, logged disclosure-recording forms per DOH protocol.
- Assemble health care records for the Long Term Care Division and Adult Psychiatric Division/CARE/Forensic Division.
- Retrieve active health records from the individual units and submit them to HIMD for assembly and analysis.
- Audited active health records according to psychiatric chart order and flagged appropriate documents for clinician's signature.
- Answer phones, file, and provide new health record numbers for the admissions department.
- Take minutes for meetings, order backlogged health records from the Record Center in Santa Fe as per NMBHI protocol.
Psychological Technician Basic
NMBHI at Las Vegas
Las Vegas, NM
01.2003 - 05.2005
- Provided direct patient care, managed filing of documents, and answered phones to support office operations.
- Performed light duty tasks including answering phones, organizing health records, copying and disassembling records for HIMD, purging outdated records, and ensuring proper filing in active long term care charts while ordering necessary supplies.
- Operated and maintained equipment for efficient facility operations.
- Conducted routine inspections to ensure safety and compliance standards.
- Assisted team in troubleshooting technical issues and resolving problems.
Customer Service Representative
The Connection
Las Vegas, NM
10.2002 - 01.2003
- Answered phones, troubleshot cricket cell phones, activated phones, and documented account details.
- Assisted customers with billing inquiries, processed payments, and clarified bill details.
- Assisted customers with inquiries and provided timely solutions.
- Processed orders and managed customer accounts effectively.
- Resolved complaints through active listening and problem-solving techniques.
Education
Luna Community College
Las Vegas, NM01-2011
New Mexico Highlands University
Las Vegas, NM10-2001
High School Diploma -
Mora High School
Mora, NM05-2000
Skills
- Prior authorization
- Healthcare operations
- Regulatory compliance
- Medical terminology proficiency
- Process improvement
- Critical thinking
- Effective time management
- Time management
- Organizational ability
- Multitasking capacity
- Problem solving
- Reliability
- Active listening
- Communication Etiquette
- Communication Etiquette
Accomplishments
- Achieved Employee of the Year status just months into the role.
- Catching Up a Backlog - Streamlined workflow to enhance productivity and minimize backlog issues.
- Acknowledged for exceptional effort and commitment.
Awards
2005, HIMD Employee of the Year
References
References available upon request.
Languages
Native/ Bilingual
Computer Experience
- Microsoft Word
- AS400
- AVATAR
- E-Copy
- Microsoft Excel
- Microsoft Outlook
- Microsoft PowerPoint
- Internet
- Patron
- ECW
- Athena
- Cerner
- Power chart
- Healthxnet
- API
- E-med
- NM PMP Aware
- Vitalware
- IKnowmed
- Mosaiq
- Epic
- Medecision
- Aria
Activities
Committed to helping others through volunteer work while fostering strong morals and values in my family.
Websites
Timeline
Authorization Lead
Christus St. Vincent Medical Center
08.2025 - Current
Infusion Therapy Authorization Coordinator
CHRISTUS St. Vincent
03.2024 - Current
Patient Care Coordinator
Christus St. Vincent
02.2016 - Current
Medical Records
Professional Home Health Care
03.2015 - 02.2016
Caregiver
Veterans Administration
11.2013 - 02.2016
Back up Supervisor
NMBHI at Las Vegas
08.2006 - 10.2013
HIMD Back up Coder
NMBHI at Las Vegas
08.2006 - 10.2013
Release of Information (ROI) Specialist
NMBHI at Las Vegas
05.2005 - 10.2013
Psychological Technician Basic
NMBHI at Las Vegas
01.2003 - 05.2005
Customer Service Representative
The Connection
10.2002 - 01.2003
Luna Community College
New Mexico Highlands University
High School Diploma -
Mora High School