Jacquelin Silva
Houston
Summary
Detail-oriented and customer-focused healthcare administrative professional with 5+ years of experience in high-volume service environments and 3+ years in medical front office and prior authorization coordination. Proven ability to manage complex insurance processes, maintain HIPAA compliance, and provide compassionate patient support. Bilingual in English and Spanish with strong communication and leadership skills.
Overview
11
11
years of professional experience
Work History
Prior Authorization Coordinator /Front Office Team Leader
Modern Pain Management
09.2021 - Current
- Submit and manage 60–80 prior authorization requests weekly, ensuring accurate CPT coding and timely processing.
- Review clinical documentation to confirm compliance with payer and insurance requirements.
- Communicate authorization approvals, denials, and pending statuses clearly to providers, staff, and patients.
- Proactively follow up on pending and denied authorizations to prevent delays in patient care.
- Maintain accurate patient records and update charts using eClinicalWorks (EMR/EHR).
- Verify insurance eligibility and work with Medicaid, Medicare, and multiple commercial carriers.
- Answer high-volume phone calls, triage inquiries, and provide professional customer support.
- Schedule patient appointments and assist with check-in and check-out processes.
- Ensure strict compliance with HIPAA regulations and patient confidentiality standards.
- Deliver compassionate, professional service to patients and families in a healthcare setting.
- Awarded Employee of the Year for outstanding performance, reliability, and leadership.
Restaurant Hostess
Backstreet Cafe
02.2017 - 03.2020
- Greeted and seated guests in a fast-paced, high-volume restaurant while maintaining a welcoming atmosphere.
- Managed reservations, phone calls, and guest inquiries with professionalism and accuracy.
- Coordinated with servers and management to ensure smooth service flow.
- Maintained organized reservation records and handled confidential guest information.
- Demonstrated adaptability and teamwork during peak service hours.
Restaurant Team Member /Drive-Thru Leader
Chick-fil-A
07.2015 - 02.2017
- Supervised drive-thru operations, tracking team productivity and order accuracy.
- Operated POS systems and handled cash transactions efficiently.
- Provided prompt, courteous service while maintaining brand standards.
- Assisted with training new team members and maintaining station cleanliness.
Education
High School Diploma -
Southwest High School
Houston, TX05-2016
Skills
- Prior Authorizations & Insurance Verification
- CPT Coding & Clinical Documentation Review
- EMR/EHR Systems (eClinicalWorks)
- Patient Scheduling & Front Desk Operations
- HIPAA Compliance & Confidentiality
- Medicaid, Medicare & Commercial Insurance
- Customer Service & Patient Relations
- Multitasking in High-Volume Environments
- Bilingual: English / Spanish
Timeline
Prior Authorization Coordinator /Front Office Team Leader
Modern Pain Management
09.2021 - Current
Restaurant Hostess
Backstreet Cafe
02.2017 - 03.2020
Restaurant Team Member /Drive-Thru Leader
Chick-fil-A
07.2015 - 02.2017
High School Diploma -
Southwest High School