Luis Aceves
Santa Ana,CA
Summary
Enthusiastic Authorizations Coordinator eager to contribute to team success through hard work, attention to detail, and excellent organizational skills. Clear understanding of obtaining funding contracts and training in operational software. Motivated to learn, grow and excel in the health industry.
Overview
6
6
years of professional experience
Work History
Authorization Coordinator
Learn It Systems
Orange, CA
04.2020 - Current
- Submitted for prior authorization with required documentation to appropriate funding source for over 500 clients per year.
- Maintained consistent follow-up on status of prior authorization requests.
- Reviewed authorizations from over 25 payer to determine approved or denied items.
- Calculated estimated copay based on current insurance benefits.
- 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 17 executives about consistent customer issues.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
Advanced Behavior Technician
Autism Spectrum Therapies
Santa Ana, CA
05.2019 - 04.2020
- Conducted functional behavior assessments, functional analysis, preference assessments and assessments of basic learning and language skills to identify target behaviors and purpose of behaviors.
- Exercised physical dexterity to safely implement crisis management interventions and therapeutic holds.
- Provided comprehensive case management services, created treatment plans and connected clients and families to appropriate resources.
- Ran individual therapy and family therapy sessions for children age 2 to 17.
- Developed and led Social Skills groups consisting of 6 children members.
Behavior Technician
Autism Spectrum Therapies
Santa Ana, CA
03.2017 - 05.2019
- Observed, monitored and recorded problem behaviors through accurate behavior-consequence data collection, graphs and anecdotal notes.
- Worked as part of collaborative team to address changing needs of children and families.
- Promoted positive interactions of children with ADHD, Autism and oppositional defiance behavior by using visual supports, simplifying communication and utilizing stress scales to turn emotions into concrete concepts.
- Implemented and established behavior strategies by setting rules, reiterating expectations and rewarding good behavior for over 40 students.
Education
Bachelor of Arts - Sociology
California State University - Long Beach
Long Beach, CA2016
Skills
- Customer Experience
- Obtaining Authorizations
- Insurance Eligibility Verifications
- Microsoft Proficiency
- Problem Anticipation and Resolution
- Records Organization and Management
- Administrative Management
- Patient Data Management Systems
- Clerical Support
- Operational Requirements
- Effective Multitasking
- Clinical Messaging
- Treatment Documentation
Accomplishments
- Documented and resolved clinical overserving of hours which led to significant loss prevention.
- Used Microsoft Excel to develop client inventory tracking spreadsheets.
- Trained and supervised new hire staff members.
- Increased direct referrals by collaborating with both commercial and Medi-Cal payors.
Languages
English
Spanish
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
One of the deep secrets of life is that all that is really worth doing is what we do for others.
Lewis Carroll
Timeline
Authorization Coordinator
Learn It Systems
04.2020 - Current
Advanced Behavior Technician
Autism Spectrum Therapies
05.2019 - 04.2020
Behavior Technician
Autism Spectrum Therapies
03.2017 - 05.2019
Bachelor of Arts - Sociology
California State University - Long Beach
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