Helen Hernandez
Hollywood,FL
Summary
Seeking a medical authorization specialist position where I can leverage my strong skills in medical coding, patient communication, and insurance verification. I aim to streamline the authorization processes to reduce denials and enhance patient satisfaction to ensure timely and accurate processing of authorizations.
Overview
13
13
years of professional experience
Work History
Medical Authorization Specialist
HCA Physician Services
Miramar, Florida
04.2024 - Current
- Provide customer service to internal and external customers related to authorization requests.
- Review authorization requests for accuracy and completeness.
- Research patient eligibility, coverage information, and benefit levels.
- Initiate and submit authorizations track approval status and deadlines.
- (EHR) Systems record retrieval and management.
- ICD10 coding systems and compliances.
- Produce insurance estimates and cost projections for Medical procedures.
- Configure and maintain accurate billing claims addresses.
Lead Authorization Coordinator
Associates MD
Plantation, Florida
03.2019 - 03.2024
- Provide training and support to junior staff pertaining to medical utilization management.
- Maintained accurate records of all authorizations in the system (EHR).
- Processed incoming authorization requests and updated customer accounts accordingly.
- Oversee productivity and workflow management.
- Collaborate with providers; liaise with insurance companies, etc.
- Track metrics and generate reports.
- Reviewed and approved authorization requests according to established criteria.
Referral Coordinator
Sanitas Medical Center
Hialeah, Florida
12.2015 - 01.2019
- Coordinate appointments with specialists and other healthcare providers.
- Verify eligibility and benefits.
- Receive, process and track patient referral requests from providers.
- Documentation and records management (EHR).
- Ensure compliance to regulatory adherence.
Behavioral Health Insurance Verifier
Compass Health Systems, P.A
North Miami, Florida
01.2012 - 12.2015
- Verify insurance coverage and eligibility for services using computer software.
- Verify and confirm all information on prior approval is accurate.
- Setup claims for maximum reimbursement.
- Liaison between insurance company and providers.
- prepare appeals for denials or rejections.
- ICD 9 compliance and regulations
- (EHR)
Education
High School Diploma -
Miami Lakes Tech High
Hialeah, Florida06-2007
Skills
- HIPAA Compliance
- Claims Management
- Medical terminology expertise
- Insurance Verification
- Knowledge of insurance policies and procedures
- Medical coding documentation
- Authorizations and referrals management
- Compliance and regulatory knowledge
- Technical proficiency
Timeline
Medical Authorization Specialist
HCA Physician Services
04.2024 - Current
Lead Authorization Coordinator
Associates MD
03.2019 - 03.2024
Referral Coordinator
Sanitas Medical Center
12.2015 - 01.2019
Behavioral Health Insurance Verifier
Compass Health Systems, P.A
01.2012 - 12.2015
High School Diploma -
Miami Lakes Tech High
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