Elizabeth Jimenez
San Diego
Summary
Experienced Authorization Specialist with 13 years of experience in the healthcare industry. Demonstrated ability to navigate authorization processes efficiently. Highly dedicated and adaptable, able to quickly learn and adapt to new systems and processes. Successful track record as an Authorization Representative, ensuring timely and accurate processing of authorizations. Strong attention to detail and commitment to providing excellent customer service.
Overview
13
13
years of professional experience
Work History
Authorization Specialist
Lorian Health
06.2024 - Current
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Requested timely authorization to maintain patient care continuity.
- Collaborated with cross-functional teams to ensure timely delivery of patient care.
- Reviewed patient orders and notes to accurately request initial and additional authorizations for the appropriate discipline.
Authorization Representative
Imaging Healthcare Specialists
08.2022 - 08.2024
- Identify and resolve issues related to insurance authorization requirements to ensure timely processing of patient claims
- Collaborate with healthcare providers offices to gather necessary medical documentation for insurance authorization
- Maintain accurate and up-to-date documentation of all insurance authorization requests and approvals
- Monitor and track insurance authorization requests to ensure timely approvals and minimize denials
- Effectively communicate with patients regarding their insurance coverage and authorization status, addressing any questions or concerns they may have
- Attend meetings and audits to identify potential areas for improvement in the insurance authorization process
- Contact insurance to verify if authorization is needed and initiate if so
- Answer multiple calls from patients, doctor offices and insurance representatives and resolve any questions they may have
Front Desk Representative
Advanced Eye and Laser Center
06.2022 - 07.2022
- Implement and maintain patient check-in and check-out processes to ensure efficient flow of patients and minimize wait times
- Implement and maintain an efficient appointment scheduling system to ensure prompt and accurate patient appointments
- Coordinate with ophthalmologists and technicians to ensure smooth patient flow and minimize wait times
- Provide exceptional customer service by greeting and assisting patients in a friendly and professional manner
- Manage and update patient insurance information to ensure accurate billing and claims processing
- Respond to patient inquiries and provide accurate information about services offered by the clinic
- Answer calls and schedule patients appointments promptly
- Call insurances to obtain coverage information for procedures
Referral Coordinator
San Diego Family Care
02.2012 - 06.2022
- Implement process improvements to enhance the efficiency and accuracy of the referral tracking system
- Establish strong relationships with healthcare providers in order to ensure efficient and timely referrals for patients
- Develop and maintain strong relationships with healthcare providers and insurance companies to ensure efficient and timely processing of referrals
- Coordinate with insurance companies to obtain authorization for referrals
- Coordinate with patients and healthcare providers to gather necessary medical records and documentation for referral processing
- Manage and track the status of all referrals to ensure timely processing and follow-up with healthcare providers and insurance companies
- Maintain accurate and up-to-date records of all referral transactions and communications
Education
High School -
Hoover High School
Skills
- Referral Processing
- Medical Records
- Customer Service
- Documentation Gathering
- EMR Systems
- ICD-10
- CPT Coding
- Fluent Spanish
- Fluent English
- Medical Terminology
- Communication Skills
- Epic Knowledge
- Fast Learner
- Adaptable
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
- Documentation and reporting
- Data entry
- Teamwork and collaboration
- Time management
- Reliability
Languages
Spanish
English
References
Jillion Harris, MD
jillionh@gmail.com
Erika Tonjes, NP
6198082004
Tammie Hale
tammielynn77@gmail.com
Zherryll Santiago
8582202722
Timeline
Authorization Specialist
Lorian Health
06.2024 - Current
Authorization Representative
Imaging Healthcare Specialists
08.2022 - 08.2024
Front Desk Representative
Advanced Eye and Laser Center
06.2022 - 07.2022
Referral Coordinator
San Diego Family Care
02.2012 - 06.2022
High School -
Hoover High School
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