Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Cassandra Gonzalez

Omaha,NE

Summary

Accomplished Authorization Specialist with a proven track record at Centene, excelling in medical terminology expertise and effective communication. Demonstrated success in enhancing care delivery through meticulous prior authorization processing and teamwork, achieving consistent productivity targets. Skilled in multitasking and problem-solving, significantly reducing processing times and fostering strong relationships with healthcare providers. Experienced with managing complex authorization processes, ensuring compliance and efficiency. Utilizes strong problem-solving abilities to streamline workflows and enhance patient satisfaction. Knowledge of industry standards and team collaboration drives successful authorization management. Professional in healthcare industry with strong background in managing authorizations and ensuring compliance. Skilled in navigating complex systems, problem-solving, and maintaining accurate records. Known for effective collaboration, adaptability, and delivering results in fast-paced environments. Reliable team player with expertise in healthcare regulations, communication, and customer service. Trained in Cloud and Trucare classic use and administration with knowledge of Medicaid. Dedicated to excellent customer service and best-in-class collaboration.

Overview

10
10
years of professional experience

Work History

Authorization Specialist

Centene
10.2022 - Current
  • Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
  • Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
  • Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
  • Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
  • Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
  • Assisted in training new team members on company policies and procedures for handling authorization requests.
  • Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
  • Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.

Referral Specialist

A-Staffing - Centene
03.2022 - 10.2022
  • Collaborated with healthcare providers to ensure accurate and complete authorization information, improving patient care coordination.
  • Streamlined authorization processes for increased efficiency, resulting in timely authorizations for patients.
  • Verified eligibility for inpatient and outpatient procedures before creating authorizations.
  • Developed strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.

Medicare Interview Specialist

Mutual of Omaha
10.2021 - 12.2021
  • Supported diversity initiatives within the company by actively seeking out and engaging with underrepresented candidates during interviews.
  • Managed scheduling and logistics for interviews, ensuring a smooth experience for both candidates and interviewers.
  • Worked closely with recruiters to understand position requirements thoroughly before conducting interviews, ensuring accuracy in assessing fit.
  • Maintained clear communication with candidates throughout the entire interview process, providing a positive experience.
  • Prepared detailed reports on interviewed candidates for underwriting reviews, helping them make informed decisions quickly and efficiently.

Policy Service Specialist

Physicans Mutual
07.2019 - 08.2020
  • Enabled informed decision-making among clients by providing clear explanations of policies.
  • Maintained strong relationships with customers by addressing inquiries promptly and providing exceptional service at all times.
  • Maximized customer retention levels by offering personalized assistance on selecting appropriate additional coverages.
  • Enhanced policy processing efficiency by streamlining workflow and implementing best practices.
  • Managed confidential client information securely maintaining compliance with industry regulations and company policies.
  • Delivered excellent customer experiences while resolving complex issues related to billing discrepancies or coverage disputes.

Policy Analyst

Mutual Of Omaha
06.2014 - 01.2017
  • Built strong relationships with internal departments for effective collaboration within the organization for policymaking purposes.
  • Maintained up-to-date knowledge of relevant scholarly literature by participating in professional development opportunities aimed at enhancing analytical skills.
  • Identified, evaluated and developed solutions to remove roadblocks to change.
  • Checked documentation for accuracy and validity on updated systems.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.
  • Modified, updated and processed existing policies.
  • Posted payments to accounts and maintained records.
  • Verified client information by analyzing existing evidence on file.

Education

Associates Degree in Health Information Management - Health Information Management

Ultimate Medical Academy
Clearwater, FL
09-2025

High School Diploma -

Omaha Bryan High School
Omaha, NE
05-2007

Skills

  • Medical terminology expertise
  • Data entry proficiency
  • Prior authorization processing
  • Documentation and paperwork
  • Effective communication skills
  • Document processing
  • Cloud and Trucare Classic expertise
  • Multitasking
  • Reliability
  • Decision-making skills
  • Problem-solving aptitude
  • Time management abilities

Accomplishments

  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Substituted for lead on team of 14 staff members.
  • Have crossed trained in multiple states such as IA, NE, MI, WI, and AR.

Timeline

Authorization Specialist

Centene
10.2022 - Current

Referral Specialist

A-Staffing - Centene
03.2022 - 10.2022

Medicare Interview Specialist

Mutual of Omaha
10.2021 - 12.2021

Policy Service Specialist

Physicans Mutual
07.2019 - 08.2020

Policy Analyst

Mutual Of Omaha
06.2014 - 01.2017

Associates Degree in Health Information Management - Health Information Management

Ultimate Medical Academy

High School Diploma -

Omaha Bryan High School
Cassandra Gonzalez