Summary
Overview
Work History
Education
Skills
Reading, spending time with family and traveling
Timeline
Generic

Loura Gonzalez

3411 Mossowood Lane,Rex

Summary

Versatile professional serves as a point of contact for patients by verifying insurance, handling paperwork and preparing records. A very patient-oriented and a helpful candidate familiar with MS Office and EHR systems coupled with thorough knowledge of medical terminology. Committed to providing personalized service and quality patient care. Organized and dedicated with a proven track record of providing exceptional customer service in fast-paced environments. Offering keen attention to detail and strong decision-making skills to manage multiple, concurrent tasks. Self-motivated work ethic to perform effectively in independent or team environments. Versatile Administrative professional well-versed in healthcare practices, compliance standards and operations. Excellent problem-solver and clear communicator with positive and upbeat personality.

Overview

25
25
years of professional experience

Work History

Surgery Coordinator

Clayton Eye Center
02.2021 - Current
  • Counseled patient about personal financial responsibility and collaborated with billing to resolve patient accounts.
  • Took pre-operative orders from surgeons and anesthesiologists for smooth operation planning.
  • Documented and collected patient data to maintain accuracy and security.
  • Maintained professional and technical knowledge by attending educational workshops, reviewing publications and participating in professional societies.
  • Communicated with patients on phone and in person to enter and update medical history in database.
  • Maintained efficient surgery schedule by monitoring daily activities and resolving potential conflicts.
  • Resolved scheduling conflicts to maintain high-quality patient services.
  • Fostered collaborative relationships among health care team by communicating, responding to requests and building rapport.
  • Updated daily operating room calendars with accurate appointment schedules.
  • Updated patient records to reflect upcoming surgeries and medical histories.
  • Coordinated testing, labs and other diagnostic data for proper clearance prior to surgery.
  • Expertly managed planning, scheduling, and coordination of outpatient procedures.
  • Collaborated with patient, referring physician and surgical specialist to coordinate pre- and post-operative care for surgical procedures.
  • Verified pre-authorizations and pre-certifications before scheduled surgeries.
  • Communicated surgery requirements to nursing teams for smooth operation delivery.
  • Verified insurance coverage and benefits and communicated directly with patient for timely scheduling of clinic appointment and surgery procedure.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Arranged pre-operative and post-operative appointments for surgical patients.
  • Educated patients about surgeries and provided treatment plan documentation.
  • Checked patients in and out and collected payments.
  • Abided by state and federal healthcare guidelines and laws and reported non-compliance issues.

Insurance Specialist/Surgery Scheduling Coordinator

Southern Regional Medical Center-Spivey Station
01.2008 - 02.2021
  • Organized and maintained patient chart filing system to promote quick data finding for staff.
  • Took pre-operative orders from surgeons and anesthesiologists for smooth operation planning.
  • Checked patients in and out and collected payments.
  • Registered and verified patient records before triage with most up-to-date information.
  • Resolved scheduling conflicts to maintain high-quality patient services.
  • Managed office logistics by scheduling appointments, maintaining files and collecting payments.
  • Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
  • Educated patients about surgeries and provided treatment plan documentation.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Managed office bookkeeping with insurance billing and patient payments.
  • Prepared and processed patient referrals and transfer requests.
  • Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
  • Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
  • Placed new supply orders, managed inventory and restocked clerical spaces.
  • Verified insurance coverage and obtained pre-authorizations.
  • Updated daily operating room calendars with accurate appointment schedules.
  • Greeted visitors and initiated triage processes for clients to streamline patient flow.
  • Assisted with medical coding and billing tasks.
  • Conducted patient intake interviews, recording and documenting relevant information.
  • Completed administrative patient intakes with case histories, insurance information and mandated forms.
  • Obtained payments from patients and scanned identification and insurance cards.
  • Coordinated with facilities to set up surgeries for.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Communicated surgery requirements to nursing teams for smooth operation delivery.
  • Arranged pre-operative and post-operative appointments for surgical patients.
  • Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
  • Updated patient records to reflect upcoming surgeries and medical histories.
  • Answered phone calls and messages for medical facility, scheduling appointments, and handling patient inquiries.
  • Expertly managed planning, scheduling, and coordination of outpatient procedures.
  • Received and routed laboratory results to correct clinical staff members.

Medical Records Clerk/Insurance Clerk/Authorization Specialist

Hendry Regional Medical Center.
12.1997 - 10.2007
  • Verified client information by analyzing existing evidence on file.
  • Input all patient data regarding claims and prior authorizations into system accurately.
  • Analyzed medical records and other documents to determine approval of requests for authorization.
  • Notified insurance agents and accounting departments of policy cancellations and changes.
  • Coordinated with contracting department to resolve payer issues.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Collected premiums and issued accurate receipts.
  • Processed patients lacking coverage for planned procedures.
  • Responded to inquiries from healthcare providers regarding prior authorization requests.
  • Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
  • Communicated effectively with staff members of operations, finance and clinical departments.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
  • Tracked referral submission during facilitation of prior authorization issuance.
  • Communicated verification and authorization status updates with department to facilitate decision-making for patient admissions and insurance coverage.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.
  • Posted payments to accounts and maintained records.
  • Developed and maintained productive working relationships with healthcare providers.
  • Checked documentation for accuracy and validity on updated systems.
  • Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
  • Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
  • Fielded telephone inquiries on authorization details from plan members and medical staff.

Education

Associate of Science - Nursing

Palm Beach Community College
Belle Glade, Fla 33430

Master of Science - Public Health Education

South University
Savannah, GA

Bachelor of Science - Public Health Education

South University
Savannah, GA
08.2016

Associate of Science - Public Health Education

South University College
Savannah, GA
04.2012

High School Diploma -

Clewiston High School
Clewiston, FL 33440
05.1988

Skills

  • Co-Pay Collection
  • Surgery Preparation
  • Route Messages
  • Payment Collection
  • Data Entry Software
  • Obtaining Authorizations
  • Operational Requirements
  • Compassionate Care
  • Accurate Recordkeeping
  • Staff Meetings
  • Insurance Pre-Certification
  • Exceptional Attention to Detail
  • Cost Advising
  • Prescription Refills
  • CPR Certified
  • Taking Client Histories
  • Pre-Authorization Management
  • Assisting with Procedures
  • Call Transfers
  • Team Goals
  • BLS Certified
  • Patient Engagement
  • Patient Health Information Access
  • Online Systems
  • Maintain Records
  • Following Up with Patients
  • Surgical Log Maintenance
  • Office Supplies and Inventory
  • Medical Records Verification
  • Reminder Calls
  • Organization and Time Management
  • Adaptable and Flexible
  • Administering Medications
  • Reading Comprehension
  • Updating Charts
  • Answer Telephones
  • Checking in Patients
  • Direct Patient Care
  • Documentation Scanning
  • Patient History Collection
  • Payment Plan Options

Reading, spending time with family and traveling

I am very family oriented. I love spending my time with my husband, children and grandchildren. In my spear time I love to read. I try and travel to a new destination once a year. 

Timeline

Surgery Coordinator

Clayton Eye Center
02.2021 - Current

Insurance Specialist/Surgery Scheduling Coordinator

Southern Regional Medical Center-Spivey Station
01.2008 - 02.2021

Medical Records Clerk/Insurance Clerk/Authorization Specialist

Hendry Regional Medical Center.
12.1997 - 10.2007

Associate of Science - Nursing

Palm Beach Community College

Master of Science - Public Health Education

South University

Bachelor of Science - Public Health Education

South University

Associate of Science - Public Health Education

South University College

High School Diploma -

Clewiston High School
Loura Gonzalez