Ivanka B Fencak
CMAA
Bonita Springs,Fl
Summary
Medical Office Specialist, organized, excellent at prioritizing, multitasking, effective case, and time management. As a professional, my goal is to secure a position with an established organization offering advancement opportunities.
Overview
39
39
years of professional experience
6
6
years of post-secondary education
Work History
Authorization Specialist
PVG, LLC
Naples, FL
10.2022 - Current
- Review of prior authorization (PA) requests and reconciliation with insurance forms
- Verifies insurance coverage and obtains authorizations if needed from insurance coverage
- Assures communication of approved outpatient procedures to medical providers and health plan members
- Answer calls from physicians’ offices, and hospitals using exceptional customer service skills
- Provide estimates of payment for procedures.
Utilization Management Coordinator I
Florida Cancer Specialists
Fort Myers, FL
01.2020 - 09.2022
- Process prior authorization requests, HIPAA guidelines, following internal policies and procedures
- Ability to work independently and collaboratively
- Outstanding accuracy in data entry and exceptional diligence
- Appropriately forwards all prior authorization requests to insurance for medical review
- Acts as a liaison between physicians, health plans, vendors, or other referral sources
- Distributes correspondence in adherence with department standards
- Maintains appropriate logs, records, and reports as established by Utilization Management Department.
Referral Coordinator/Pre-Authorization Specialist
Summa Health
Medina, OH
04.2018 - 09.2019
- Resolves pre-certification, registration, and case-related concerns prior to a patient's appointment
- Gathers pertinent information from insurance carriers to make certain the patient's financial obligations for services provided
- Provides support to clinical staff to facilitate the administrative components of clinical referrals for assorted services
- Enters referrals and documents communications, actions, and other data in an information system.
Pre-Authorization Specialist
MetroHealth Medical Center
Cleveland, OH
06.2016 - 11.2017
- Accurately enter required information into computer database
- Review of prior authorization requests and reconciliation with insurance forms
- Attach incoming information to Epic database and follow established procedures for distributing information for further review
- Call back providers with precertification numbers as needed and file completed precertification requested as per established procedures
- Maintain patient confidentiality as defined by state, federal and company regulations.
Practice Support Specialist
MetroHealth Medical Center
Cleveland, OH
03.2014 - 06.2016
- Create an inviting environment to clients by providing excellent, cheerful, and ever helpful service
- Update clients contact and payer information as needed
- Update and request Prior Authorizations for medications and working with pharmacies and insurances.
Front Desk Receptionist
ProCare Wellness Center
Seven Hills, OH
06.2013 - 03.2014
- Answering incoming calls /Arranging appointments for clients
- Filing and record keeping
- Bookkeeping or cashiering duties.
Caregiver/STNA
12.2008 - 06.2013
General Nurse, Slovakia
06.1984 - 07.2008
Education
Medina County Career Center
Medina, OH 01.2018 - 01.2019
Diploma - Medical Office Specialist
Kaplan Carrier Institute
Cleveland, OH 2012 - 2013
General Nurse -
Nursing School
Slovakia 1980.09 - 1984.06
Skills
Computer SkillsPrinting/Scanning/FaxingCustomer ServiceDocumentation/EfficiencyExpert in Medical TerminologyICD10 / CPT / HCPC / EPIC / CENTRICITYMS Office - Word, Outlook, Excel, PowerPointUtilization ManagementAnalytical Person/ Collaborator
Authorizations understanding
Timeline
Authorization Specialist
PVG, LLC
10.2022 - Current
Utilization Management Coordinator I
Florida Cancer Specialists
01.2020 - 09.2022
Referral Coordinator/Pre-Authorization Specialist
Summa Health
04.2018 - 09.2019
Medina County Career Center
01.2018 - 01.2019
Pre-Authorization Specialist
MetroHealth Medical Center
06.2016 - 11.2017
Practice Support Specialist
MetroHealth Medical Center
03.2014 - 06.2016
Front Desk Receptionist
ProCare Wellness Center
06.2013 - 03.2014
Diploma - Medical Office Specialist
Kaplan Carrier Institute
2012 - 2013
Caregiver/STNA
12.2008 - 06.2013
General Nurse, Slovakia
06.1984 - 07.2008
General Nurse -
Nursing School
1980.09 - 1984.06