Jacqueline Quintana
Orlando,FL
Summary
Efficient Authorization Specialist with comprehensive knowledge of medical insurance policies, and procedures. Demonstrated ability to liaise effectively between patients, healthcare providers, vendors, and insurance companies for smooth transactions. Strengths include strong problem-solving skills, thoroughness in documentation and a keen eye for identifying inconsistencies. Proven impact in previous roles includes streamlined authorization processes, improved patient satisfaction rates, and reduced claim denials.
Overview
5
5
years of professional experience
Work History
Authorization Specialist
Doctors Medical LLC
Orlando, FL
11.2023 - Current
- Reviewed authorization requests for accuracy and completeness.
- Researched patient eligibility, coverage information, and benefit levels.
- Maintained current knowledge of applicable regulations, laws, and standards.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Processed prior authorization requests in accordance with departmental guidelines.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Ensured timely submission of accurate documentation to support payment of services rendered by providers.
- Monitored daily workflow queues within the department ensuring all tasks are completed accurately and timely.
Restaurant Manager
Chickn'Cone
Orlando & Winter Garden, FL
03.2022 - 07.2023
- Ensured compliance with all food safety regulations and sanitation standards.
- Supervised and trained staff in customer service, food handling, and safety protocols.
- Managed day-to-day operations of restaurant, including scheduling, budgeting, and inventory control.
- Developed strategies for improved operational efficiency and customer satisfaction.
- Oversaw the recruitment, hiring, onboarding, training, scheduling and evaluation of employees.
- Conducted weekly team meetings to discuss performance issues and provide feedback.
- Monitored stock levels of ingredients to ensure timely delivery of fresh produce.
- Assisted with kitchen preparation during peak times as needed.
- Adhered to all health department regulations regarding food storage and preparation.
Orchid Medical Inc
DME Care Coordinator
Orlando, FL
03.2021 - 03.2022
- Responsible for coordinating with medical providers, injured workers, and the carriers through the management of the DME process.
- Able to multitask in a high-volume, fast-paced, team-oriented environment.
- Good written and verbal communication skills.
- Able to meet designated deadlines.
- Strong problem-solving and critical thinking skills.
- Strong interpersonal, time management, and organizational skills.
- Able to work both independently and within a team environment.
Patient Care Coordinator
Stand Up MRI
Orlando, FL
12.2019 - 03.2021
- Coordinated patient care services with the medical team to ensure quality and timely delivery of care.
- Assisted in creating a positive environment for patients, family members, and staff by providing excellent customer service.
- Scheduled appointments for patients and coordinated follow-up visits as needed.
- Maintained accurate records of all patient care activities using electronic health record systems.
- Performed administrative duties such as filing paperwork, answering phones and scheduling appointments.
Education
Associate of Arts - Accounting And Business Management
New York City Technical College
02-1992
High School Diploma -
Samuel Gompers Technical High School
06-1991
Skills
- Insurance Verification
- Data entry proficiency
- Claims Management
- Medical coding knowledge
- HIPAA Compliance
- Medical terminology expertise
- Prior authorization processing
- Recordkeeping and data input
- Telephone Etiquette
- Proficiency in Microsoft Word, Excel
- Documentation and paperwork
- Verbal Communication
- Documentation And Reporting
Timeline
Authorization Specialist
Doctors Medical LLC
11.2023 - Current
Restaurant Manager
Chickn'Cone
03.2022 - 07.2023
Orchid Medical Inc
DME Care Coordinator
03.2021 - 03.2022
Patient Care Coordinator
Stand Up MRI
12.2019 - 03.2021
Associate of Arts - Accounting And Business Management
New York City Technical College
High School Diploma -
Samuel Gompers Technical High School