ERIKZ ROMERO
Fort Myers,FL
Summary
Professional in healthcare industry with strong background in managing authorizations and ensuring compliance. Skilled in navigating complex systems, problem-solving, and maintaining accurate records. Known for effective collaboration, adaptability, and delivering results in fast-paced environments. Reliable team player with expertise in healthcare regulations, communication, and customer service.
Overview
15
15
years of professional experience
Work History
Authorization Specialist/Claim Hold Report Specialist
GENESISCARE USA OF FLORIDA
07.2018 - Current
- Run insurance benefits and scan information.
- Acquire and read Rx and other clinical documentation.
- Request authorizations for rad onc/radiology procedures.
- Notate patient account and scan in authorization in patient chart and notify treatment offices for scheduling.
- Processed patient authorization requests efficiently to ensure timely treatment access.
- Utilized electronic health records systems to track authorization statuses and outcomes.
- Collaborated with clinical staff to resolve authorization discrepancies and expedite approvals.
- Developed training materials for new staff on authorization protocols and best practices.
- Mentored junior team members in navigating complex authorization cases effectively.
- Analyzed workflow processes to identify areas for improvement and enhance operational efficiency.
- Implemented standardized procedures that improved accuracy of documentation and reduced errors.
- 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.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Review claim hold reports and resolve any issues or input missing data if possible and/or send to designated auth specialist for review if complicated.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
Medical Assistant
Pulmonary Physicians Of South Florida
01.2016 - Current
- Calling in and greeting patient
- Taking patient vital signs
- Triaging patient and inputting information given in EHR
- Assisting physician with basic medical procedures
- Performing 6 Minute Walks for portable Oxygen qualification
- Giving patient oxygen when needed
- Giving Flu/Pneumonia Vaccines
- Sending electronic prescriptions to patient pharmacy
- Answering phone calls
- Setting up appointments for new and existing patients electronically
Medical Front Office Assistant
Center For Custom Prosthetics
01.2017 - 07.2018
- Checking In Patients
- Scheduling Appointments
- Running Insurance/Checking Benefits
- Initiating Procedure Authorizations
- Checking Authorization and Claim status
- Checking Out Patients
- Work with Availity Program
- Work with Act! Scheduling software
- Assist patients on the phone etc.
Cashier/Sales/Customer Service
Miami Home Centers (True Value)
01.2011 - 01.2016
- Greet customers when they enter store
- Handle Register: Cash, Checks, Credit/Debit Cards, Cash Accounts, Charge accounts etc.
- POS Proficient
- Assist customers with merchandise or any questions they might have in-store or over the phone
- Inform customers about sales, promotions or offers in-store and online
- Handle office paperwork on spare time
Medical Assistant (Externship)
Medigo Urgent Care
01.2014 - 01.2014
- Greeting patient in front desk
- Taking payment and/or Insurance Information
- Basic patient triaging
- Phlebotomy/Basic Laboratory Work
- Drug screening
- Basic X-Ray Imaging
- Assisting Physician with basic medical procedures/exams
Education
Medical Assistant Technician -
Florida Career College
Miami, FL06.2014
Childcare Provider Certification - undefined
Miami Dade Community College (Wolfson Campus)
Miami Beach, FL10.2012
High School Completion Diploma - undefined
Miami Beach Senior High School
Miami Beach, FL01.2010
Skills
- NextGen Software Proficient
- EHR Software proficient (Patient Data Entry)
- Intergy proficient
- Owan proficient
- Filing
- Fast Learner, Energetic and Highly Efficient and tenacious
- Dedicated
- Bilingual
- Fair Computer Knowledge
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
- Fair office/Secretary Skills
- Documentation and reporting
- Microsoft office
- Data entry
- Record keeping
- Telephone etiquette
- Confidentiality
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Authorization Specialist/Claim Hold Report Specialist
GENESISCARE USA OF FLORIDA
07.2018 - Current
Medical Front Office Assistant
Center For Custom Prosthetics
01.2017 - 07.2018
Medical Assistant
Pulmonary Physicians Of South Florida
01.2016 - Current
Medical Assistant (Externship)
Medigo Urgent Care
01.2014 - 01.2014
Cashier/Sales/Customer Service
Miami Home Centers (True Value)
01.2011 - 01.2016
Childcare Provider Certification - undefined
Miami Dade Community College (Wolfson Campus)
High School Completion Diploma - undefined
Miami Beach Senior High School
Medical Assistant Technician -
Florida Career College