Jennifer Ruiz
Brentwood
Summary
Results-driven Authorization Specialist with expertise in prior authorizations, insurance verification, and Workers’ Compensation case management. Drive timely approvals through proactive carrier and adjuster coordination. Minimize denials, accelerate turnaround times, ensure strict compliance with payer guidelines, and protect revenue integrity.
Overview
8
8
years of professional experience
Work History
Authorization Specialist
Nyu Langone SouthShore Neurologic
712 Main Street Islip NY 11751
05.2022 - Current
- Processed private insurance authorizations efficiently, ensuring compliance with regulatory requirements.
- Processed worker’s compensation authorizations for all neurological procedures and diagnostic testing.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
Medical Coordinator
South Shore Neurologic Associates P.C
Islip, NY
02.2019 - 04.2022
- Facilitated communication with insurance providers to verify coverage details and secure billing authorization.
- Applied HIPAA privacy and security regulations while handling patient information.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Managed all payments processing, invoicing and collections tasks.
- Performed insurance verification, pre-certification and pre-authorization.
- Prepared and posted copays and balances
- Obtained referrals and authorizations
Administrative Assistant
Taxsaver Enterprise
Brentwood, NY
01.2018 - 04.2018
- Answered phone calls and emails to provide information, resulting in effective business correspondence.
- Inventoried and ordered supplies for office.
- Scheduled appointments, meetings and events for management staff.
- Responded effectively to sensitive inquiries or complaints.
- Maintained accurate department and customer records.
- Managed physical and digital files, monitored spreadsheets and updated reports to coordinate project materials.
- Organized files, developed spreadsheets, faxed reports and scanned documents, maintaining front desk and reception area in neat and organized fashion.
- Reviewed and updated account information in company computer system.
- Collected and organized information for entry, prioritizing entries to increase efficiency.
Education
High School Diploma -
Brentwood High School
Brentwood, NY06.2011
Skills
- Prior Authorizations
- Insurance Verification
- Workers’ Compensation
- Benefits Investigation
- Medical Documentation
- CPT ICD-10 Coding
- Denial Management
- EMR Systems
- High Volume Processing
- Attention to Detail
- Time Management
- Provider Communication
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Accomplishments
- Electronic Medical Records (EMR/EHR)
- Prior Authorization Portals
- Workers’ Comp Systems
- Insurance Web Portals
- Microsoft Excel
Timeline
Authorization Specialist
Nyu Langone SouthShore Neurologic
05.2022 - Current
Medical Coordinator
South Shore Neurologic Associates P.C
02.2019 - 04.2022
Administrative Assistant
Taxsaver Enterprise
01.2018 - 04.2018
High School Diploma -
Brentwood High School