Leticia Espinoza
Prior Authorization and referral Coordinator
Watsonville,CA
Overview
18
18
years of professional experience
Work History
Referral Authorization Coordinator
Palo Alto Medical Foundation
03.2010 - 01.2023
- Reviewed authorizations from payer to determine approved or denied items.
- Reviewed documentation for accuracy and assessment.
- Maintained consistent follow-up on status of prior authorization requests.
- Submitted for prior authorization with required documentation to appropriate funding source.
- Gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
- Maintained files and controlled records to show correspondence activities.
- Communicated with executives about consistent customer issues.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
- Carried out day-day-day duties accurately and efficiently.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Worked flexible hours; night, weekend, and holiday shifts.
- Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Worked effectively in fast-paced environments.
- Worked well in a team setting, providing support and guidance.
Patient Account Representative
Palo Alto Medical Foundation
Santa Cruz, CA
12.2005 - 03.2010
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Kept reception area clean and neat to give visitors positive first impression.
- Confirmed appointments, communicated with clients and updated client records.
- Answered central telephone system and directed calls accordingly.
- Front desk duties for Imaging department.
- Entered accurate information onto appropriate forms and computer system.
- Obtained appropriate signatures.
- Escorted patients to destination if required.
- Maintained scheduling for department and/or specialized procedures.
- Coordinated services with physicians' offices, and other related departments, verifying room and equipment availability if necessary.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Responded to inquiries from callers seeking information.
- Managed multiple tasks and met time-sensitive deadlines.
- Provided clerical support to company employees by copying, faxing, and filing documents.
- Restocked supplies and submitted purchase orders to maintain stock levels.
- Organized, maintained and updated information in computer databases.
- Operated multi-line telephone system to answer and direct high volume of calls.
Education
Certified Medical Administrative Assistant
Santa Cruz County ROP
Capitola, CAMedical Insurance Billing
AAPC
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Skills
- Confidential Records Management
- Scheduling
- Registration Processing
- Clinic Administration
- Computer Proficiency
- Revenue Operations
- Effective Multitasking
- Medical Information Collection
- Greeting Visitors
- Office Equipment
- Obtaining Authorizations
- Specialist Referrals
- Clerical Support
- Medical Terminology
- Epic
- Teams
- Word
- Outlook
- Excel
- Customer Experience
- Diagnostic Codes
- Authorization Management
- Prior Authorization
- Authorization Certificates
- Authorization Coordination
- Authorization Process
- Authorization Verification
- Authorization Procedures
- Maintenance Authorization
- Referral Coordination
- Referral Tracking
- Referral Arrangements
- Confidential Records Management
- Patient Referral
- Referral Verification
- Referral Management
- Referral Processing
- Prior Authorization Verification
- Electronic Authorization Processing
- Pre-Authorization Management
- Prior Authorization Processing
- Insurance Authorization Management
- Medical Referral Management
Quote
Nothing is a waste of time if you use the experience wisely.
Auguste Rodin
Timeline
Referral Authorization Coordinator
Palo Alto Medical Foundation
03.2010 - 01.2023
Patient Account Representative
Palo Alto Medical Foundation
12.2005 - 03.2010
Certified Medical Administrative Assistant
Santa Cruz County ROP
Medical Insurance Billing
AAPC