Cecilia Palenzuela
Las Vegas,NV
Summary
Dependable Prior Authorization Specialist with a career spent handling various administrative responsibilities in fast-paced settings. Bilingual individual dedicated to finding solutions to issues and obtaining prior authorization information for patients. Ready to tackle new challenges in an office-based environment.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist/PT Intake
Las Vegas Pain Institute and Medical Center
Las Vegas, USA
02.2022 - Current
- Submit and manage prior authorization requests to insurance companies for various medical services, including surgeries, procedures, and medications
- Collect and review necessary medical documentation from healthcare providers to support authorization requests
- This includes medical records, treatment plans, and clinical notes
- Verify patients' insurance coverage and understand the specific requirements for prior authorization of the insurer
- Involves direct communication with insurance companies to clarify coverage details
- Inform patients about the authorization process, including any potential delays in treatment due to pending authorizations
- Assist patients with questions about their insurance coverage and the status of their authorization requests
- Conduct regular follow-ups with insurance companies to check the status of prior authorization requests and resolve any issues or denials
- Handle denials of prior authorization by reviewing the reasons for denial, coordinating with healthcare providers to gather additional information if needed, and submit appeal requests
- Ensure compliance with healthcare regulations, insurance policies, and privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA)
- Maintain detailed records of all prior authorization requests, communications, and outcomes
- Ensure accuracy and confidentiality of patient and treatment information
Server/Wait Staff
Instawork
Las Vegas, USA
10.2021 - Current
- Greet customers with a warm and inviting smile
- Seat customers, provide excellent service, take orders, ring up check, clear table and setup and help distribute tips
Front Desk Intake Specialist
Advanced Primary Care
Las Vegas, USA
07.2021 - 01.2022
- Greet patients, insurance verification/eligibility, inpatient check in, answer calls, schedule, lab orders, referrals, FMLA, Accommodation papers, prep charts, fax, file and census
Office Manager
Palmer Electric
Las Vegas, USA
09.2020 - 07.2021
- Ensure projects run smoothly by employing efficient and competent staff, analyze existing administrative procedures, ensure cost and expenses of projects are in strict compliance with the client's budget, creating and executing quality control programs, ensuring the maintenance and promotions of safety on construction sites by enforcing safety regulations and guidelines, liaising and working with architects, surveyors, engineers and project managers to check and review plans and monitoring construction project progress and costs and ensuring that they are within budget
- Manage and oversee daily operations of accounting
- Accounts payable
- Accounts receivable
- Quarterly taxes
- Reconciliation
- Month and year end
- W2 and 1099's
- Payroll
Education
Bachelor's - Accounting
Seattle University
01.1991
Skills
- QuickBooks
- Time management
- Viewpoint
- Acrobat
- Excel
- Microsoft Office
- PowerPoint
- Word
- Detail oriented
- Construction Management Software
- Tax Experience
- Paychex
- Workers' Compensation
- Bank Reconciliation
- Accounts Payable
- Account reconciliation
- Microsoft Excel
- Administrative experience
- Microsoft Word
- Microsoft Outlook
- Communication skills
- Payroll
- Accounting
- Customer service
- Accounts receivable
- Construction
- Customer support
- Personal assistant experience
- Medicare
- Medical terminology
- Microsoft PowerPoint
- Serving
- Restaurant experience
- POS
- Leadership
- Budgeting
- Sales
- Cash register
- Driving
- Quality control
- Purchasing
- Recruiting
- Bookkeeping
- Training & development
Certification
- Food Handler Certification
- Certified Notary Public
Assessments
- Attention to detail, Proficient, 03/01/22
- Spreadsheets with Microsoft Excel, Proficient, 02/01/22
Personal Information
Work Permit: Authorized to work in the US for any employer
Publications
Certified Notary Public
Timeline
Prior Authorization Specialist/PT Intake
Las Vegas Pain Institute and Medical Center
02.2022 - Current
Server/Wait Staff
Instawork
10.2021 - Current
Front Desk Intake Specialist
Advanced Primary Care
07.2021 - 01.2022
Office Manager
Palmer Electric
09.2020 - 07.2021
- Food Handler Certification
- Certified Notary Public
Bachelor's - Accounting
Seattle University
Similar Profiles
Jacquita GeissJacquita Geiss
Authorizations Specialist at Las Vegas Pain Institute and Medical CenterAuthorizations Specialist at Las Vegas Pain Institute and Medical Center
Jose GonzalezJose Gonzalez
Lead Medical Assistant at Las Vegas Spine And Pain CenterLead Medical Assistant at Las Vegas Spine And Pain Center
Maylin CervantesMaylin Cervantes
Student/Customer Nail Technician at Cosmetology institute of Las VegasStudent/Customer Nail Technician at Cosmetology institute of Las Vegas