Angelina Martinez
Orange,CA
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.
Overview
34
34
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Sunrise Respiratory Care
11.2022 - Current
- Input all patient data regarding claims and prior authorizations into system accurately.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
Health Technician
Maxim Healthcare
09.2021 - 06.2022
- Maintained observation on any student with Covid-19 symptoms.
- Cleaned and sterilized the monitoring room on a daily basis.
- Maintained charts of the student's symptoms.
- Assisted in the weekly Covid-19 testing of all students.
- Provided the families of the school community with medical resources.
- Communicated with school staff and parents of updated policies and procedures to be followed determined by the school district.
Pharmacy Assistant
CVS Pharmacy
08.1989 - 06.2014
- Obtained authorizations for our customers for medications that were not covered by their health plan.
- Called doctor's offices to request the needed documents in order to obtain authorizations.
- Received incoming supplies and stocked in correct locations.
- Answered telephones and provided information about order status, store hours and pharmacy procedures.
- Called insurances to verify eligibility for our customers.
- Assisted in the inventory process of the pharmacy.
Education
High School Diploma -
Santiago Canyon College
Orange, CA12.2018
Skills
- Excellent communication skills
- Loyal and hard working
- Compassionate and caring by nature
- Bilingual (Fluent in English and Spanish)
Certification
CPR Certification
First Aid Certification
Languages
Spanish
Native or Bilingual
Timeline
Prior Authorization Specialist
Sunrise Respiratory Care
11.2022 - Current
Health Technician
Maxim Healthcare
09.2021 - 06.2022
Pharmacy Assistant
CVS Pharmacy
08.1989 - 06.2014
High School Diploma -
Santiago Canyon College
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