Hilda Ramirez
Murrieta,CA
Summary
To contribute to an organization offering advancement opportunities utilizing my abilities and skills developed through my professional work experience as a Medical Receptionist.
Results-driven professional with background in authorization coordination, known for high standards and commitment to excellence. Expertise in managing authorization processes and improving operational workflows. Recognized for strong collaborative skills and adaptability, ensuring seamless team dynamics and goal achievement.
Professional Authorization Coordinator with extensive experience in managing authorization processes in healthcare. Proven ability to facilitate team collaboration and adapt to changing needs, ensuring efficient workflow and compliance. Strong skills in communication, problem-solving, and data management. Dependable and results-driven, consistently delivering high-quality outcomes.
Overview
13
13
years of professional experience
Work History
Specialty Authorization Coordinator
Los Angeles Hematology and Oncology Network
07.2022 - Current
- Coordinated pre-authorization processes for medical services, ensuring compliance with insurance requirements.
- Managed patient referrals and verification of eligibility to expedite healthcare access.
- Streamlined authorization workflows, improving turnaround time on requests by implementing best practices.
- Collaborated with healthcare providers to resolve authorization issues and enhance patient care coordination.
- Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
- Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
- Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
- Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
- Maintained consistent follow-up on status of prior authorization requests.
- Maintained up-to-date knowledge of insurance policies, enabling accurate evaluation of coverage eligibility criteria for patients.
Surgery Scheduler
Dr. David Mello M.D Gastroenterologist
04.2018 - 11.2021
- Schedule patient's office consultation or follow up appointment according to the patient's request related to physician, day and time preference, office location, or first available opening
- Obtain assistance/direction if patient's office consultation or follow up request requires urgency due to patient symptoms/chief complaint
- Schedule patient's appointment at the appropriate site location per insurance coverage
- Inform patient of site facility fees if location chosen requires fee
- Obtain patient information accurately and verifies patient registration and insurance information in the Practice Management System and Electronic Medical Record (EMR) and updates information if necessary
- Explain office location/detailed directions to patient for appointment
- Communicate appointment information and patient instructions accurately, appropriately, professionally and in a timely manner to patients &/or patient family members, nursing home staff, etc
- Cancel and Reschedule out-patient consultation and follow-up appointments appropriately notifying each department
- Conduct basic patient education with use of handouts, pamphlets, maps, new patient packets, etc
- Work collaboratively with physician/mid-level, physician nurse/clinical assistant to optimize patient care procedure information and patient instructions appropriately and in a timely manner to patients &/or patient family members, nursing home staff, etc
- Completes follow-up work for each patient scheduled before end of work day
- Appropriately schedules necessary labs, Endoscopy procedures, x-rays, or any other ancillary/appointments for patients considering proper insurance coverage per location
- Schedules EGD/EGD w/ Dilatation/EUS/Colonoscopy/Capsule Endoscopy at appropriate site., Insurance verification HMO, PPO, MEDICARE MEDICAL Checking patients in and out
Medical Receptionist
Dr. Margarita Ovelan MD Neurology
07.2013 - 04.2018
- Answering phones scheduling appointments preparing charts
- Submitting referrals/Authorizations
- CPT/Coding
- Scheduling patients for surgery
- EMR Trans med
- Insurance verification HMO, PPO, MEDICARE MEDICAL
- Checking patients in and out
Skills
- Effective task prioritization
- Effective time management
- Strong communication skills
- Professionalism and ethics
- Critical thinking
- Healthcare regulations
- Process improvement strategies
- Medical coding
- Patient confidentiality compliance
- Medical terminology proficiency
- Insurance verification expertise
- Organizational growth
- Prior authorization
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Problem-solving abilities
- Time management
- Multitasking
- Attention to detail
- Adaptability and flexibility
- Self motivation
- Office administration
- Team collaboration
Languages
English
Spanish
Timeline
Specialty Authorization Coordinator
Los Angeles Hematology and Oncology Network
07.2022 - Current
Surgery Scheduler
Dr. David Mello M.D Gastroenterologist
04.2018 - 11.2021
Medical Receptionist
Dr. Margarita Ovelan MD Neurology
07.2013 - 04.2018