Elena Sanchez Candell
Tavares
Summary
Experienced bilingual professional in administration and customer service fields.
Demonstrates a strong service-oriented mindset, prioritizing the needs of others. Committed to delivering high-quality service and continuously expanding knowledge through fast learning. Possesses problem-solving abilities to effectively address challenges, along with excellent communication and time management skills for seamless coordination and collaboration within the administrative side of an office environment. Recognized for accuracy and efficiency in handling tasks, ensuring optimal outcomes for customers.
Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
12
12
years of professional experience
Work History
Prior Authorization Specialist / Customer Service
BVM Healthcare Inc.
10.2017 - Current
- Company Overview: Medical Supplier
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Processing referrals for durable medical equipment using Brightree medical software
- Contacting patients, social workers and medical staff; to answer inquiries and providing recommendations regarding the order process
- Assisting customers over the phone, email, or in-person, offering an excellent quality customer service experience and personalized attention
- Contacting insurances' provider service line for insurance verification, eligibility and benefits, coverage, network status, authorization requirements
- Educating clients and referral source on medical equipment indications and coverage.
- Checking claims status via web portals (Availity, Blue Cross Blue Shield, CGS, Medicaid, WellCare, Aetna, Molina, CountyCare, etc.) and contacting claim departments over the phone when required
Bilingual Medical Assistant
Onsite Health Care
03.2017 - 10.2017
- Company Overview: Home health Agency
- Assisting internal/family medicine physicians when performing home visiting care
- Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
- Arranging referrals for specialty medical care and testing (Laboratory and imaging)
- Obtained client medical history, medication information, symptoms, vital signs and current complaints at intake
- Collected and documented patient medical information such as blood pressure and weight.
- Performed medical records management, including filing, organizing and scanning documents.
- Built strong relationships with patients through effective communication skills that foster trust in the clinic's commitment to quality care.
- Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
- Implemented care and efficiency improvements to support and enhance office operations.
- Helped improve patient outcomes by educating and advising on relevant treatments and care.
- Oriented and trained new staff on proper procedures and policies.
- Taught patients about medications, procedures, and care plan instructions.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Improved patient experiences by efficiently managing appointments and maintaining organized medical records.
Bilingual Front Desk Management
Your Medicos S.C.
11.2016 - 04.2017
- Greeting customers and directing them to the appropriate provider or department
- Giving information to customers and answering their questions
- Answering incoming calls and scheduling appointments
- Sending insurance information to verification
- Collecting payments
- Worked effectively in fast-paced environments.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Organized and detail-oriented with a strong work ethic.
- Paid attention to detail while completing assignments.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Learned and adapted quickly to new technology and software applications.
General Intern Physician
Hospital Naval de Guayaquil
09.2013 - 09.2015
- Company Overview: Ecuador
- Prescribe or administer treatment, therapy, medication, vaccination and other specialized medical care to treat or prevent illness, disease or injury
- Order, perform and interpret tests and analyze records, reports, and examination information to diagnose patients' condition
- Collect, record, and maintain patient information, such as medical history, reports, and examination results
- Monitor patients' conditions and progress and reevaluate treatments as necessary
- Refer patients to medical specialists or other practitioners when necessary
- Schedule and confirm patient diagnostic appointments, surgeries, or medical consultation
- Interview patients to complete documents, case histories, or forms, such as intake or insurance forms
- Compile and record medical charts, reports, or correspondence, using typewriter or personal computer
- Ecuador
Education
Medicine -
Universidad Catolica Santiago de Guayaquil
02.2014
Skills
- Computer and Internet Proficiency (Microsoft Office products and various Electronic Medical Records software)
- Customer service and telephone etiquette with outstanding professionalism
- Effective communication, organizational, and task prioritization skills
- Multitasking Abilities and Problem-solving abilities
- Date entry experience with the Ability to type around 60wpm
- Insurance benefits verification and Prior authorization process
- Medical terminology knowledge (ICD-10 coding) and HIPAA compliance
- Claims processing, payment collection, and records maintenance experience
- Bilingual (English - Spanish)
Languages
English
Native or Bilingual
Timeline
Prior Authorization Specialist / Customer Service
BVM Healthcare Inc.
10.2017 - Current
Bilingual Medical Assistant
Onsite Health Care
03.2017 - 10.2017
Bilingual Front Desk Management
Your Medicos S.C.
11.2016 - 04.2017
General Intern Physician
Hospital Naval de Guayaquil
09.2013 - 09.2015
Medicine -
Universidad Catolica Santiago de Guayaquil
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