Motivated and detail-oriented Medical Authorization Manager with three years of experience successfully managing office operations to achieve optimal efficiency. Proficient in maintaining patient information using electronic medical records while ensuring compliance with health care regulations. Experienced in medical billing and coding with excellent organization, communication, and time management skills. Offering flexibility, teamwork, and ethic.
Overview
15
15
years of professional experience
Work History
Authorization Manager
SimonMed Imaging
02.2021 - Current
Manage non-clinical administrative tasks over 5 different Regions including, CA, NV, TX, CO, and AZ for over 150 employees
Maintain inventory and order supplies to keep department functioning smoothly
Prepare patient appointments by verifying insurance and authorization to ensure accuracy
Improved operations to find a workable solutions to secure over 85% completion rate of authorization approvals and reduced patient appointment cancellations by 56% resulting in $68M in revenue for 2022
Recruited, hired, and trained all staff, providing direct supervision, ongoing staff development, develop training material, and continuing coaching and guidance to 1 supervisor and 7 team leads
Established departmental organization, work priorities, workflow and team responsibilities due to change in workload, schedule changes or emergency situations and communicate to staff as necessary to reduced overtime labor cost by 20%
Acting back up in absence of a director, attend leadership meetings and made strategic plans for the department
Established and maintained working relationship with Providers and Peers throughout the organization
Assisted providers to understand Authorization process to ensure continuation of patient care
Ensured that we are in compliance with HIPPA and adhere to relevant quality standards to improve the quality of care and services provided to our patients
Provide coaching, mentoring, performance evaluation to employees including disciplinary actions
I encourage staff to learn and grow personally and professionally by coaching, mentoring, and modeling leadership qualities and professional behavior
Address issues impacting or impeding resolution of the Denial Variance, related to denials, underpayments, and credits due
Explained upcoming treatment preparation, instructions, and other facts to patients.
Worked with patients to schedule tests and procedures.
Maintained confidentiality of patient data and condition to safeguard health information.
Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
Upheld confidentiality requirements and regulatory compliance guidelines.
Assisted patients with completing necessary paperwork and forms to provide healthcare facilities with essential information to bill for services.
Communicated with insurance companies to verify coverage and obtain authorizations for medical procedures.
Coordinated transportation to get patients to and from medical appointments.
Provided complete patient assessments and communicated with patients to understand medical histories.
Accommodate STAT appointment requests, registering patients, obtaining appropriate Insurance information, while managing two Concierge Accounts, and providing back-up to onsite Concierge.
Adding new Physicians to RIS system, and tech assisting as needed.
Communicating Denials with Patients and their Providers.
Update patient's demographics or insurance information, and explaining medical benefits with Patients.
Training new hire groups on how to obtain medical prior authorizations and creating a training folder for reference on how to obtain medical authorizations.
Daily interaction with other departments to assist patients and providers with problems or questions and act as a facilitator to resolve questions or concerns.
Experience Storage Counselor
OPENTECH ALLIANCE
05.2012 - 02.2014
Offered direction and gave constructive feedback to motivate team members.
Built customer confidence by actively listening to concerns and giving resolutions.
Trained and motivated new associates on daily routines to sustain business productivity.
Analyzed trends and provided recommendations to management regarding quality of service such as speed of resolution.
Collaborated with internal stakeholders to close gaps and improve customer experience.
Obtain new Customers and manage their Accounts
Assist with Payments and Resolve any Conflicts in a Timely Manner
Contributed to Training and discovering customer needs and appropriately suggest product to enhance Service and meet Sales Targets.
Assist with Payments and Resolve any Conflicts in a Timely Manner.
Shift Manager
POPEYES CHICKEN AND BISCUIT
02.2009 - 05.2012
Follow health, safety, and sanitation guidelines for all products
Follow and direct other to follow store policies and procedures for operational flow at each station
Follow cash handling procedures and cash register policies, as well as assisted the Store Manager with accounting and Banking responsibilities
Demonstrate and ensured all company policies and procedures are followed
Be able to Management Labor and employee scheduling.
Kept employees operating productively and working on task to meet business and customer needs.
Coached crew members to optimize performance and motivate toward more efficient work.
Cooperated with coworkers to improve customer experience and manage storefront.
Excelled in every store position and regularly backed up front-line staff.
Tracked receipts, employee hours, and inventory movements.
Consistently exhibited calm demeanor during periods of high volume or unusual events to keep store operating smoothly and set positive example for shift team.
Adhered to company standards and compliance requirements for operations and cleanliness of areas.
Troubleshot equipment to reduce service calls and downtime.
Implemented policies and standard operating procedures for continuous improvement.
Education
High School Diploma -
PEORIA HIGH SCHOOL
PEORIA, AZ
04.2011
Skills
10 years' Experience in Customer Service and ability to Resolve Conflicts
Strong Organizational Skills and Ability to Multi-task
Ability to maintain customer records by updating account information
10 years' Experience of Computer Skills and Over-the-Phone Skills
Time Management
Team leadership
Quick Learner and fast thinker
Knowledge of ICD10 code/CPT codes
HIPAA trained
Medical terminology knowledge
Referral verification
Insurance eligibility verification and pre-certification processes
Patient scheduling
Proficient in Microsoft Windows, Office, Word, Outlook, Power Point and Excel