Elizabeth Casares
Palmdale ,CA
Summary
Possessing communication and organizational skills, adept at managing and prioritizing tasks efficiently. Committed to ensuring authorization processes, verification, and familiar with letter of agreement processing that enhance patient care and operational efficiency.
Overview
9
9
years of professional experience
Work History
Financial Clearance Specialist
Keck Medical Center of USC
09.2017 - Current
- Ensured timely referrals for specialty care or diagnostic tests by verifying coverage and obtaining necessary preauthorizations.
- Established contact with ordering physician's office to resolve any issues or to collect missing vital information.
- Assisted clinics and patients with understanding their insurance policies, benefits, and limitations to promote informed decision-making regarding healthcare services.
- Handle various insurance plans, including HMOs, PPOs, government-sponsored programs, Medi-cal , military , and workers comp ensuring accurate verification.
- Reduced claim denials by diligently researching and resolving discrepancies in policy information.
- Managed high-volume insurance verifications and authorizations within a timeframe to ensure clearance before services are rendered
- Submitted for prior authorization with required documentation to appropriate securing approval.
- Familiar when a specific policy is not contracted and a letter of agreement is required or if there are any capitation
- Participated in cross-training within the company that collaborates on special projects requiring contributions from multiple departments or specialties.
Insurance Verification Specialist
Beverly Hills Cancer Center
02.2016 - 12.2016
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
Education
Trade Certificate of Completion - Medical Billing And Coding
American Career College
CA12-2015
High School Diploma -
Lynwood High School
Lynwood, CA06-2014
Skills
- Teamwork and collaboration
- Communication and interpersonal skills
- Customer service
- Problem-solving
- Multitasking
- Prior authorization processing
- Reliability
- Critical thinking
- Documentation and correspondence
Languages
Spanish
Full Professional
English
Full Professional
Timeline
Financial Clearance Specialist
Keck Medical Center of USC
09.2017 - Current
Insurance Verification Specialist
Beverly Hills Cancer Center
02.2016 - 12.2016
Trade Certificate of Completion - Medical Billing And Coding
American Career College
High School Diploma -
Lynwood High School
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