JOANNA ROJAS
Austin,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Efficient Authorization Specialist known for high productivity and ability to complete tasks swiftly and accurately. Specialized skills in insurance verification, and regulatory compliance that ensure smooth authorization processes. Excel in communication, problem-solving, and time management which facilitate effective collaboration with healthcare providers and insurance companies.
Overview
20
20
years of professional experience
Work History
Surgery Scheduler
Dell Children's Neuroscience
AUSTIN, TX
08.2024 - Current
- Scheduled surgical procedures for patients in pediatric neuroscience department.
- Managed communication between patients and medical staff regarding procedure details.
- Booked surgeries according to physician volume and maintained prompt turnaround times.
- Created and managed surgical schedules for multiple surgeons.
- Collaborated and established strong working relationships with physicians, supervisors and colleagues.
- Checked patient insurance and collected pre-authorizations from providers.
- Maintained a high level of customer service by responding promptly to inquiries from patients and families about their care plans and procedures.
- Attended weekly meetings with department managers in order to review progress of surgical scheduling operations.
- Arranged hospital admissions for patients as required.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Collaborated with insurance providers to verify coverage for surgical services.
Case Management Coordinator
Dell Children's Neuroscience
Austin, TX
10.2022 - 08.2024
- Responsible for obtaining prior authorization prior to services being performed
- Obtained pre certifications for office visit, outpatient procedures, imaging, labs, and Inpatient stays
- Responsible for tracking, extending authorizations, letters of medical necessity, denials and appeals
- Cooperated with local service providers, outreach workers, case managers and collaborative agencies to facilitate services for members
- Facilitated communication between different departments in order to resolve issues quickly
- Monitored daily workflow queues within the department ensuring all tasks are completed accurately and timely
- Processed prior authorization requests in accordance with departmental guidelines
- Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers
- Followed up on pending prior authorization requests to ensure timely processing
- Trained new staff on prior authorization procedures and company policies
- Notified ordering providers of denied authorizations
- Educated healthcare providers on prior authorization requirements and insurance formulary changes.
- Maintained a high level of customer service by responding promptly to inquiries from patients and families about their care plans and procedures.
- Adhered to HIPAA guidelines when handling confidential information.
Customer Service Representative
Dell Children's Neuroscience
Austin, TX
08.2020 - 09.2022
- Successfully managed information using athena software, compass, patient records, organized daily mail, incoming and outgoing faxes
- Handled successfully 100+ incoming and outgoing telephone calls daily and directed them to appropriate department
- Greeted patients, checking in & out
- Scheduled 30+ patients appointments each shift including R/S
- Collect any outstanding balance, co-pays or self pays
- Excellent communication skills and organizational skills with the ability to multi-task, set priorities, and meet deadlines
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor
- Answered customer inquiries via phone, email, and chat
- Scheduled appointments for patients according to their need or request
- Coordinated referral services between primary care providers and specialty care centers
- Completed electronic documentation, prior insurance authorizations and scheduling of appointments for patients.
Delivery Team
Nordstrom Rack
Austin, TX
01.2020 - 06.2020
- Assist with markdowns while organizing and cleaning the stock department
- Package orders, print labels and place items in orders, organized the packages by designated delivery date
- Prep for daily shipments and new merchandise
- Send out damaged items & returned items to the warehouse.
Merchandise Support Team
Nordstrom Rack
Austin, TX
02.2019 - 12.2019
- Tracked daily inventory while keeping the floor replenished with new merchandise
- Ensure the products were up to date on price including markdowns/scanning products throughout the store
- Merchandised store appropriately with floor sets and movements to reflect planograms from corporate
- Broke down boxes for garbage and recycling
- Greeted guests and vendors to assist in navigating space
- Handled incoming calls and directed callers to appropriate department or employee
- Monitored office services mailbox for business support needs and requests
- Received and distributed mail, letters and packages.
Women Shoe Department Assistant Manager
Nordstrom
Austin, TX
01.2017 - 01.2018
- Trained new hires and managed 30 employees
- Helped the shoe department team exceed goal by $20,000 while achieving personal sales goal
- Assisted with hiring and scheduling employees along with creating team daily assignments and work schedules
- Prep and organized for events held throughout the store.
Assistant Manager
Nordstrom Rack
Austin, TX
02.2015 - 12.2017
- Hire and train develop and motivate your team success to achieve department volume and productivity goals by developing and executing a business
- Ensures operational excellence by performing managerial tasks, such as scheduling, maintaining inventory, and/or evaluating employee performance
- Establish sales goals, manage budgets, devise sales forecasts, and consistently maximize sales and profits
- Manage merchandise selection, window displays, and stocking, working directly with vendors.
Lead MN's & Kid's
Nordstrom Rack
Austin, TX
01.2014 - 01.2015
- Strong experience of a retail environment and knowledge of sales and service
- Ability to supervise, direct, and motivate staff
- Superior knowledge of the safety policies and procedures
- Resolving client complaints and answering customer questions
- Growing sales by building strong and influential relationships
- Organize inventory daily paperwork for store audits.
Cashier & Sales Floor Support
Nordstrom Rack
East Palo Alto, CA
04.2011 - 01.2013
- Assist customers with a variety of transactions through a seamless, friendly experience
- The ability to prioritize multiple tasks in a fast-paced environment
- Clear, effective communication with strong interpersonal skills
- Defuse customer situations and provide resolution in a timely and effective manner
- Ensure the security and privacy of customer information through education, compliance, and resolution of issues.
Cashier & Assistant Manager
McDonald's
Belmont, CA
02.2009 - 03.2011
- Maintained high standards of customer service during high-volume, fast-paced operations
- Mastered point-of-service computer system for automated order taking
- Handled currency and credit transactions quickly and accurately
- Ensure that employees comply with health and food safety standards
- Checks food temperatures and/or prepares areas for daily operations
- Assisted in creating budgets for each store that included labor costs, food costs, rent/mortgage payments, utilities, etc., as well as monitoring actual expenses against budget monthly.
Cashier & Sales Support
Mervyn's
Redwood City, CA
06.2006 - 01.2008
- Answers customers' questions about merchandise
- Assists customers with purchase decisions
- Retrieves merchandise from the sales floor, stock room
- Collects payment using the store point of sale system
- Processes returns and exchanges
- Communicated clearly and positively with coworkers and management.
Education
High School -
Redwood High School
Skills
- Effective Customer Communication
- Team Building
- Adaptability and Flexibility
- Organizational Skills
- Friendly, Positive Attitude
- Computer Skills
- Detail-Oriented
- Insurance Verification
- Deadline-oriented
- Work Planning and Prioritization
- Patient Scheduling
- Critical thinking abilities
- Self Motivation
- Spreadsheet Management
- Patient Communication
- Calendar coordination
- Staff Training
- Decision-Making
- Fluent Spanish
- Multitasking
- Problem-solving abilities
- Scheduling proficiency
Timeline
Surgery Scheduler
Dell Children's Neuroscience
08.2024 - Current
Case Management Coordinator
Dell Children's Neuroscience
10.2022 - 08.2024
Customer Service Representative
Dell Children's Neuroscience
08.2020 - 09.2022
Delivery Team
Nordstrom Rack
01.2020 - 06.2020
Merchandise Support Team
Nordstrom Rack
02.2019 - 12.2019
Women Shoe Department Assistant Manager
Nordstrom
01.2017 - 01.2018
Assistant Manager
Nordstrom Rack
02.2015 - 12.2017
Lead MN's & Kid's
Nordstrom Rack
01.2014 - 01.2015
Cashier & Sales Floor Support
Nordstrom Rack
04.2011 - 01.2013
Cashier & Assistant Manager
McDonald's
02.2009 - 03.2011
Cashier & Sales Support
Mervyn's
06.2006 - 01.2008
High School -
Redwood High School