Diego Diaz
Zephyrhills,FL
Overview
4
4
years of professional experience
2
2
Languages
Work History
Coordinator Long Term Care Medicaid
Bright Home Care
02.2025 - Current
- Reviewed and verified insurance authorizations from multiple health insurance providers, ensuring accuracy of patient information, approved service units, and authorized hours.
- Validated authorization details to confirm the correct service codes (S9122 – Personal Care and S5130 – Homemaker) were assigned and matched the services provided to each patient.
- Entered and maintained patient demographics, insurance information, case manager details, authorized hours, and service authorizations in a HIPAA-compliant electronic health record (EHR) system.
- Ensured all authorization records were accurate, complete, and compliant with payer guidelines and agency policies before processing patient services.
- Performed comprehensive patient chart audits every 60 days to verify that care plans, patient information, and clinical documentation were current and compliant with regulatory requirements.
- Reviewed patient records for updates related to health status, demographic changes, and care plans, ensuring documentation remained accurate and up to date.
- Maintained strict confidentiality of Protected Health Information (PHI) while handling patient records in accordance with HIPAA regulations.
- Collaborated with insurance companies, case managers, and internal care teams to resolve authorization discrepancies and maintain continuity of patient care.
Health Insurance Agent
ELG United Insurance Agents
02.2022 - Current
- Educated clients on Aetna health insurance plans, benefits, coverage options, and eligibility requirements, helping them select plans that best met their healthcare needs.
- Built and maintained strong relationships with clients by providing exceptional customer service and ongoing support throughout the enrollment process.
- Explained health insurance benefits, coverage limitations, provider networks, deductibles, copayments, and out-of-pocket costs in a clear and easy-to-understand manner.
Education
Associate of Science - Business Administration And Management
Hillsborough Community College
Tampa, FL05-2024
Skills
- HIPAA Compliance
- Electronic Health Records (EHR)
- Medical Documentation
- Communication & Cross-functional Collaboration
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Coordinator Long Term Care Medicaid
Bright Home Care
02.2025 - Current
Health Insurance Agent
ELG United Insurance Agents
02.2022 - Current
Associate of Science - Business Administration And Management
Hillsborough Community College