Maisbelis Denis
Tampa,FL
Summary
Dynamic Authorization Specialist with a proven track record at Florida Digestive of Tampa Bay, adept at optimizing workflows and enhancing communication across departments. Skilled in prior authorization processing and HIPAA compliance, consistently exceeding productivity targets while ensuring meticulous documentation and patient care. Recognized for improving processing times and accuracy in claims management.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Authorization Specialist and Procedure Scheduler
Florida Digestive of Tampa Bay
02.2025 - Current
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
Authorization Specialist
Haven Home Health LLC
07.2024 - 01.2025
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
Authorization Specialist
Advent Health Tampa
03.2024 - 06.2024
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
Referral Coordinator
Pulmonary & Sleep of Tampa Bay
02.2022 - 02.2024
- Scheduled appointments with specialists on behalf of clients.
- Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
- Maintained a high level of accuracy in referral documentation, ensuring smooth transitions between healthcare providers.
- Processed referral requests from patients, doctors and other health care professionals.
- Responded to patient inquiries to offer timely updates regarding referral status.
- Served as a liaison between primary care physicians, specialists, and patients to ensure timely access to needed services.
Education
High School Diploma -
Cuba
Cuba06-2010
Skills
- Medical terminology expertise
- Claims management
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
- Appointment scheduling
- Documentation and paperwork
- Documentation and reporting
Certification
Teacher
Languages
Spanish
Native or Bilingual
English
Professional Working
Timeline
Authorization Specialist and Procedure Scheduler
Florida Digestive of Tampa Bay
02.2025 - Current
Authorization Specialist
Haven Home Health LLC
07.2024 - 01.2025
Authorization Specialist
Advent Health Tampa
03.2024 - 06.2024
Referral Coordinator
Pulmonary & Sleep of Tampa Bay
02.2022 - 02.2024
High School Diploma -
Cuba