Gina Rodriguez
Wyoming,Minnesota
Summary
Achieved operational excellence by leading a dedicated team in enhancing patient services. Improved workflow efficiency through strategic oversight of scheduling and daily operations. Resolved challenges in patient registration and insurance verification to maintain high-quality service delivery.
Overview
12
12
years of professional experience
Work History
Access Center Lead
Children's Minnesota
10.2025 - Current
- Lead and support an assigned team within the department while promoting an excellent patient experience.
- Perform daily patient registration/referral tasks, ensuring accuracy of demographic, financial, and consent information.
- Support teams operations, coordinate workflow, delegate responsibilities, and resolve operational issues to maintain efficiency.
- Mentor, train, and educate new employees, providing guidance to support professional development.
- Participate in the hiring process, including interviewing and evaluating prospective candidates.
- Manage staff schedules to ensure appropriate coverage and smooth departmental operations.
- Utilize web-based verification systems to confirm insurance coverage and expedite reimbursement.
- Serve as liaison between patients, families, clinics, and services
Senior Prior Authorization Specialist
Children's Minnesota
Greater Minneapolis-St. Paul Area
04.2023 - 10.2025
- - Secured service authorizations at Children’s Minnesota, significantly reducing out-of-pocket expenses for patients and their families.
- - Assessed insurance eligibility and benefits to ensure compliance with third-party pre-service requirements.
- - Managed approval and denial processes, obtaining waivers and cost estimates for non-covered services to support informed patient decisions.
- - Deliver an exceptional patient experience by collecting accurate demographic and insurance data for outpatient and mental health services.
- -Served as a liaison between Children’s Minnesota providers and insurance carriers, facilitating appointment types and prior authorization processes.
- Reviewed coverage criteria, limitations, exclusions, and provided timely updates on authorization approvals or denials, along with guidance on subsequent steps to ensure smooth patient visits.
Reimbursement Authorization Coordinator
Tactile Medical
Minneapolis, Minnesota, United States
05.2021 - 04.2023
- - Obtained payer authorizations, certifications, and referrals to maximize reimbursement and streamline patient access.
- -Expedited coverage requests and managed authorizations, denials, and prescription approvals with accuracy and efficiency.
- -Communicated payer findings to internal teams while maintaining compliance with productivity and quality standards.
- -Educated payers on product benefits and partnered with cross-functional departments to ensure seamless order processing.
- -Analyzed payer and authorization trends to identify process improvements and provide insights to leadership.
- -Assisted in developing reimbursement operations procedures, ensuring compliance with HIPAA and regulatory guidelines.
Reimbursement Specialist
Hill-Rom
04.2016 - 04.2021
- -Compiled clinical documentation to validate medical necessity for durable medical equipment (DME).
- -Prepared and submitted prior authorization requests to insurance companies and government payers to secure coverage.
- -Negotiated with out-of-network payers to obtain single-case agreements or in-network exceptions.
- -Communicated deductible, copay, and out-of-pocket costs to patients with clarity and empathy.
- -Processed payer approvals to maximize reimbursement and optimize collection potential.
- -Ensured compliance with government and commercial insurance policies, regulations, and documentation standards.
Case Manager/DME Coordinator
Proactive Healthcare Physical Medicine
St Paul, Minnesota, United States
01.2014 - 04.2016
- -Facilitated staff meetings and conducted personnel evaluations to support performance and professional development.
- -Oversaw daily staff assignments and clinic operations to ensure efficiency and quality patient care.
- -Assisted with administering foot neuropathy injections under provider supervision.
- -Provided natural and homeopathic health guidance to patients as part of holistic care.
- -Managed billing procedures, processed claims, and performed insurance verifications to optimize reimbursement.
- -Maintained accurate and compliant medical records in accordance with healthcare regulations.
Education
Medical Assistant Diploma -
Everest Institute
Eagan, MN01.2006
Timeline
Access Center Lead
Children's Minnesota
10.2025 - Current
Senior Prior Authorization Specialist
Children's Minnesota
04.2023 - 10.2025
Reimbursement Authorization Coordinator
Tactile Medical
05.2021 - 04.2023
Reimbursement Specialist
Hill-Rom
04.2016 - 04.2021
Case Manager/DME Coordinator
Proactive Healthcare Physical Medicine
01.2014 - 04.2016
Medical Assistant Diploma -
Everest Institute