Hala Aguilar
Fullerton,CA
Summary
- Compassionate professional with a versatile background in healthcare administration. Known for strong rapport building and empathy contributing to successful outcomes.
- Creative and passionate about working with children, families, and groups.
- Passionate about incorporating humanistic therapeutic approach along with cognitive behavioral therapy.
- Coachable, and passionate about learning from the experts and implementing what I learned to help others.
Overview
7
7
years of professional experience
Work History
Authorization Specialist
Patterns Behavioral Services
12.2025 - Current
- Track the expiring dates of ABA authorization for children with Autism and manage to obtain new authorizations by the deadlines.
- Coordinate with the clinical supervisors to obtain the progress reports for the members on time.
- Reach out to the contracted health plans for updates on the process of obtaining a new authorization,
- Coordinate peer review meetings with the clinical team and the health plans to go over some of the denials or additional information needed.
- Update the systems we use (Artemis and Central Reach) with the authorization information which can vary for each health plan by CPT codes, units and hours.
Payor Relation Manager
Patterns Behavioral Services
09.2023 - Current
- Manage Credentialing for all types of behavioral health providers with the contracted health plans
- Contact the health plans and attend trainings to maintain the credentialing guidelines and tools for each health plan
- Process providers recredentialing by the given deadlines.
- Update the credentialing guide monthly
- Assist providers with creating their CAQH profiles and NPPES accounts
- Communicate and collaborate with providers on a daily basis to obtain required documents to complete the credentialing process
Credentialing Specialist
Landmark Health
05.2021 - 08.2022
- Managed the providers' onboarding process
- Worked with providers to meet the enrollment deadlines
- Created providers' credentialing portfolios
- Updated providers' state licenses, DEA licenses, and Control Substance
- Renewed and obtained new state licenses for providers.
- Communicated with leadership department for providers' assignments and obtained required signed documents before the deadlines.
- Enrolled providers with health plans
- Communicated with the health plans regarding any enrollments updates
- Updated the system
- Used tracking tools to keep track of the onboarding process
- Processed Medicare applications using PECOS
- Updated providers' CAQH profile after having providers' authorizations.
- Created providers' profiles in Modio (Credentialing Platform)
- Generated and edited reports to submit to the leadership team
Provider Information Management Coordinator
Prospect Medical Group
10.2018 - 05.2021
- Enrolled providers with health plans.
- Special Project leader
- Notified health plans of terms, and demographic changes.
- Updated the system with new information.
- Updated Malpractice Insurance, state licenses, and DEA licenses.
- Verified providers licenses, and NPI and updated the system.
- Collected PID from health plans websites and updated the roster.
- Worked on updating health plans roster, and meeting the deadlines.
- Worked on special projects, and helped meeting the deadlines.
- Contacted providers' offices to obtain required documents for the
- Followed up on health plans' submissions until the end of the process.
Education
Master of Science - Marriage And Family Therapy
Pepperdine University
Malibu, CA07-2027
Master of Arts - Psychology
Pepperdine University
Malibu, CA06-2023
Bachelor of Science - Nutrition Sciences
Albaath University
Out Of State 06-2014
Skills
Communication, Rapport Building, Problem Solving, Empathy, Motivational Interviewing, Multiculturalism, Creativity, Time Management
Languages
Arabic
Native or Bilingual
English
Full Professional
Timeline
Authorization Specialist
Patterns Behavioral Services
12.2025 - Current
Payor Relation Manager
Patterns Behavioral Services
09.2023 - Current
Credentialing Specialist
Landmark Health
05.2021 - 08.2022
Provider Information Management Coordinator
Prospect Medical Group
10.2018 - 05.2021
Master of Science - Marriage And Family Therapy
Pepperdine University
Master of Arts - Psychology
Pepperdine University
Bachelor of Science - Nutrition Sciences
Albaath University