Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Giselle Flores

Edison,NJ

Summary

Talented professional considered knowledgeable leader and dedicated problem solver. Brings 10 years of valuable expertise to forward company objectives. Attentive to detail with experience in coordinating projects, programs and improvements.

Overview

14
14
years of professional experience

Work History

Patient Authorization Specialist

MSKCC
10.2014 - Current
  • Contact Insurance Companies to initiate prior authorization for inpatient and outpatient procedures
  • Complete authorizations and referrals for services, including appointments and procedures
  • Review patient's medical history and insurance coverage for approval
  • Contact referring physicians for additional information as needed
  • Single Case Agreement Coordination
  • Input new patient information and update information in our system
  • Monitor schedule for potential issues
  • Complete billing documentation
  • Assist with other clerical tasks as needed
  • Contact patients via telephone prior to their scheduled appointment, and obtaining their demographic and financial information according to departmental documentation guidelines
  • Generating Medical Record Numbers as requested by any clinical areas that may need tests reviewed
  • Discussing financial options (in person or by telephone) with Managed Care Initiative patients who are considering additional services at Memorial
  • Providing patient with information regarding hospital billing and other administrative procedures
  • Follows up after the patient’s consult visit to determine status of actions taken and decisions made about continuing treatment at MSKCC
  • Using all system resources and completing thorough account analysis to respond to inquiries
  • Informing patients about their financial responsibilities, options and actions to be taken.

Biller

NJSS
04.2011 - 10.2014
  • Handled customer billing inquiries and resolved issues in a timely manner
  • Processed customer payments quickly and accurately
  • Updated customer information in the billing system
  • Assisted the finance department in the preparation of invoicing and billing reports
  • Trained and mentored billing specialists on new software and best practices.

Project Coordinator

PAIN MANAGEMENT GROUP
01.2010 - 04.2011
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
  • Restocked supplies and placed purchase orders to maintain adequate stock levels.
  • Executed record filing system to improve document organization and management.
  • Scheduled office meetings and client appointments for staff teams.
  • Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
  • Created and maintained databases to track and record customer data.
  • Developed and updated spreadsheets and databases to track, analyze, and report on performance and sales data.
  • Coordinated and scheduled meetings and conference calls to optimize scheduling of senior staff.
  • Assisted development and implementation of new administrative procedures.
  • Sorted and distributed office mail and recorded incoming shipments for corporate records.
  • Developed strategies to streamline and improve office procedures.
  • Processed customer orders accurately and within agreed timeframes to meet service standards.
  • Drafted correspondence and other documents for CEO and department heads in company's voice.
  • Reviewed documentation to verify conformance with established project criteria.
  • Oversaw workflow and conducted month-end reconciliation of jobs.
  • Managed online communications from social media, email and website sources.
  • Guided project team staff to drive project success.
  • Provided outstanding service to all parties involved with project, promoting effective and lasting business relationships.
  • Coordinated meetings with all pertinent parties and set up remote calls using [Software].
  • Conducted research and gathered key information for use in upcoming project planning.
  • Kept projects on schedule by managing deadlines and adjusting workflows.
  • Supervised multiple projects from project start through delivery by prioritizing needs and delegating assignments.
  • Liaised between departments to facilitate communication and keep appropriate parties updated on project developments.
  • Managed competing demands and professionally adapted to frequent change, delays and unexpected events.

Education

Rutgers University
05.2024

Skills

  • Bilingual Fluent (Spanish/English)
  • Microsoft Applications
  • Citrix (EPIC/Centricity Logician EMR)
  • Adobe
  • 50-60 WPM
  • Effective Communication Skills
  • Telephone Etiquette
  • Resource Information
  • Project Coordination
  • Task Delegation
  • Personnel Management
  • Deadline Adherence

References

Furnished Upon Request

Timeline

Patient Authorization Specialist

MSKCC
10.2014 - Current

Biller

NJSS
04.2011 - 10.2014

Project Coordinator

PAIN MANAGEMENT GROUP
01.2010 - 04.2011

Rutgers University

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Giselle Flores