LUZ LEPE
Las Vegas,NV
Summary
Hardworking professional with experience in office and remote operations, administrative support, and customer service. Highly organized and self-motivated with excellent communication and interpersonal skills. Demonstrated ability to prioritize tasks and meet deadlines.
Overview
14
14
years of professional experience
Work History
Prior Authorization Specialist / Insurance Verification Specialist
Teladoc
Manhasset
01.2022 - 05.2024
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Evaluate authorizes approval, and communicates decisions for pharmacy requests according to clinical guidelines.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Followed up on pending prior authorization requests to ensure timely processing.
- Processed appeals in a timely manner as per policy guidelines.
- Input claim, prior authorization, and other important medical data into system.
- Analyzed complex health plan contracts to determine benefit coverage levels for services rendered.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Checked documentation for appropriate coding, catching errors and making revisions.
Medical Assistant Supervisor / Surgery Scheduler
Gynecologist Frank J
Las Vegas, NV
01.2012 - 12.2021
- Developed and maintained positive working relationships with medical staff, patients, and families.
- Performed administrative duties such as scheduling shifts, approving time off requests.
- Facilitated weekly meetings with office staff members to review changes in policy or procedure.
- Monitored inventory levels of medical supplies and medications in order to maintain adequate stock levels at all times.
- Adhered strictly to HIPAA protocols regarding patient confidentiality at all times.
- Enforced safety standards in accordance with OSHA regulations and HIPAA guidelines.
- Provided leadership and supervision to a medical assistant team of 5 ensuring that all tasks were completed in a timely manner.
- Ensured that all required documents were obtained prior to scheduled procedures.
- Collaborated with surgeons and anesthesiologists to ensure proper coordination of resources needed for each procedure.
- Communicated with ancillary departments on patient's behalf during the entire pre-operative process.
- Maintained a high level of customer service by responding promptly to inquiries from patients and families about their care plans and procedures.
Medical Administration Assistant
Hamon Medical Center
Las Vegas, NV
03.2010 - 03.2011
- Created new patient files and retrieved existing records for patient intake appointments.
- Collected copayments from patients at time of service according to established guidelines.
- Answered incoming calls regarding appointment times, prescription refills, billing inquiries, and other related topics.
- Checked-in patients at reception desk by verifying insurance eligibility through online systems and applications.
- Coordinated referrals to outside health providers when necessary; followed up on referrals as needed.
- Maintained accurate records of collections, adjustments and denials in the system.
- Responded to inquiries from patients, physicians and other healthcare providers regarding medical records.
Education
Medical Assistant Diploma -
College of Southern Nevada
01.2012
High School Diploma -
Las Vegas High School
01.2005
Skills
- Customer Service
- ICD-10 and CPT Coding Skills
- Medical Terminology
- Time Management
- Care Plan
- Order Entry
- Microsoft Outlook / Excel
- Google Suite / Docs
Languages
Spanish
Timeline
Prior Authorization Specialist / Insurance Verification Specialist
Teladoc
01.2022 - 05.2024
Medical Assistant Supervisor / Surgery Scheduler
Gynecologist Frank J
01.2012 - 12.2021
Medical Administration Assistant
Hamon Medical Center
03.2010 - 03.2011
Medical Assistant Diploma -
College of Southern Nevada
High School Diploma -
Las Vegas High School
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