Resourceful Specialist offering expertise in problem-solving, data analysis and customer service. Adept at quickly learning new technologies and processes for driving success. Proven track record of successfully managing multiple projects and developing innovative solutions.
Overview
12
12
years of professional experience
Work History
Reimbursement Pre-Authorization Specialist II
Boston Scientific
06.2023 - Current
Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
Expedited the approval process for vital medical procedures by maintaining a strong working relationship with insurance providers.
Streamlined communication between healthcare providers, Sales reps, and insurance companies to facilitate seamless patient care.
Enhanced workflow management within the department, implementing strategies to prioritize urgent cases and manage workload effectively.
Optimized turnaround times for prior authorization requests, collaborating closely with physicians and clinical staff to expedite necessary treatments.
Authorized surgical requests in accordance with applicable plan guidelines.
Authorization Coordinator
Medtronic
02.2018 - 06.2023
Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
Streamlined authorization processes by implementing a centralized tracking system for pending and approved requests.
Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
Maintained up-to-date knowledge of insurance policies, enabling accurate evaluation of coverage eligibility criteria for patients.
Marketing and Community Relations Coordinator
Heritage-Regal Medical Group
05.2014 - 02.2018
Coordinated activities and executed quality preventive services and educational programs to help improve quality of life and health.
Educate the community and build awareness, retain membership and drive enrolment.
Build relationships and engaged with professional, civic and private organizations in collaborative efforts to reach common market segments and meet common goals, as well as support company core values.
Liaised with marketing and PR colleagues to promote special events in social calendars.
Evaluated and selected service providers and vendors according to customer requirements.
Managed administrative logistics of events planning, event booking and event promotions.
ER Patient Access Representative
Henry Mayo Newhall Hospital
03.2012 - 04.2014
Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients.
Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
Checking-in, registering patients in the emergency room, prepare patient accounts for billing, verify insurance, obtain benefit information, collect co-payments and patient demographic information.
Update patient accounts and prepare accounts for patient admits. PBX and telecommunications experience.