Isela Oropeza
Socorro,TX
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
11
11
years of professional experience
Work History
Authorizations Representative
RadNet Inc.
10.2023 - Current
- Monitor incoming patient orders and gather information needed to complete the pre-authorization.
- Collaborated with healthcare providers to ensure accurate billing codes for various procedures.
- Verify patient’s insurance coverage with providers for medical procedures, diagnostic testing.
- Ensured timely communication with healthcare providers, delivering prompt updates on the status of authorization requests.
- Streamlined workflows for faster response times and improved productivity, managing a high volume of daily tasks.
- Expedited urgent requests by prioritizing tasks effectively, ensuring efficient handling of time-sensitive cases.
- Demonstrated exceptional attention to detail while handling sensitive personal information, adhering to HIPAA guidelines and maintaining confidentiality.
- Maximized accuracy of authorization decisions by thoroughly analyzing medical records and related documents against established criteria.
- Informed customers of alternative options when authorizations were denied, providing guidance to support informed decision making.
- Actively participated in team meetings and discussions to share insights, discuss challenges, and identify opportunities for improvement within the department.
- Verified by telephone or internet eligibility and benefits for third-party payer insurance from information provided on patient registration form.
- Enhanced customer satisfaction by efficiently processing authorization requests and verifying eligibility.
Insurance Verification Representative
Medtronic Inc.
06.2014 - 10.2023
- Verify patient’s insurance coverage with providers for medical supplies
- Advise patients on financial responsibility, Explanation of Benefits, and obtain medical records as needed.
- Enhanced customer satisfaction with prompt and accurate insurance verifications for medical services.
- Reduced claim denials by thoroughly reviewing patient eligibility and coverage details.
- Improved efficiency by streamlining insurance verification processes for patient intake.
- Collaborated with healthcare providers to ensure accurate billing codes for various procedures.
- Maintained up-to-date knowledge of insurance policies, regulations, and industry trends to provide accurate information to clients.
- Resolved discrepancies in insurance claims by efficiently communicating with patients and carriers.
- Prevented revenue loss by identifying potential coverage issues and informing appropriate parties in a timely manner.
- Promoted positive client relationships through empathetic communication and meticulous attention to detail during the verification process.
- Expedited service delivery by promptly addressing questions from patients, providers, and insurers regarding coverage details or policy changes.
- Increased overall accuracy of billing department''s work through close collaboration with colleagues on complex cases requiring additional research or clarification on coverage specifics.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Customer Service Representative
02.2013 - 06.2014
- Conducted follow on training to coworkers on computer applications and service calls
- Consulted patients on the accuracy of the information they provided and updated them on the status of their orders.
Mortgage Document Processor
Millennium Group (USAA)
08.2012 - 11.2012
- Provided status updates throughout the mortgage loan process to customers
- Liaison between member and underwriter.
Education
Legal Office Administration -
International Business College
02.2004
Skills
- Follow-Up Skills
- Policy Interpretation
- Exceptional Communication
- Claims Processing
- Empathy and understanding
- Regulatory compliance
- Active listening
- Organizational skills
Languages
Spanish
Native or Bilingual
Timeline
Authorizations Representative
RadNet Inc.
10.2023 - Current
Insurance Verification Representative
Medtronic Inc.
06.2014 - 10.2023
Customer Service Representative
02.2013 - 06.2014
Mortgage Document Processor
Millennium Group (USAA)
08.2012 - 11.2012
Legal Office Administration -
International Business College
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