Marcella Reyes
Ralls,Texas
Summary
Reliable and punctual Staffing Coordinator with a strong track record in fast-paced Home Health environments. Demonstrated willingness to take on any necessary task to support the team and contribute to business success. Highly self-motivated and skilled in multitasking, effectively managing multiple responsibilities simultaneously. Dedicated team player with excellent interpersonal skills, making me a valuable asset as a people person.
Overview
37
37
years of professional experience
Work History
Authorization Specialist
Intrepid USA
03.2021 - Current
- Obtain authorizations via phone & providers portals.
- Reduced processing times by effectively managing a high volume of authorizations.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- 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.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Make sure claims are paid at allowed amount with contructural adjustments on EOBs.
Staffing Services Coordinator
Girling Community Care
10.2019 - Current
- Seeking potential PCA & create work schedules
- Communicate with field supervisors, clients & PCA's of any changes in authorizations or schedules
- Verifying visits & Maintain my Vesta (EVV)
- Submit proper documentation to caseworkers in a timely manner
- Assist in answering incoming phone calls
- Discovered and resolved complex employee issues that affected management and business decisions.
CNA
08.1992 - Current
Medical Office Specialist
IBC
10.1987 - Current
Therapist Coordinator
Angels of Care
01.2019 - 09.2019
- Verified benefits & attained authorization from BCBS, United HC & Aetna
- Submitted & Obtain Therapy Authorization from Superior, Amerigroup, TMHP, and FirstCare
- Submitted Therapy Initial Evaluations & Re-Evaluations to physicians offices for signature
- Created therapist schedules & confirmed schedules for payroll
- Coordinated therapist to new clients
- Entered new referrals & new therapist
- Assisted in answering & transferring phone calls
- Communicated with clients & parents or guardians
- Order supplies for therapist
Outside Sales Representative
Lowe's
05.2018 - 07.2019
- Assist customers with customer service, water plants, down stock merchandise, assist customers in loading merchandise
- Document the non-sellable items in OSLG
Therapist Coordinator
BrightStar
03.2015 - 04.2018
- Submitted & Obtained Therapy Authorization from Superior, Amerigroup, TMHP, and FirstCare
- Submitted Therapy Initial Evaluations & Re-Evaluations to physicians office for signature
- Created therapist schedules & confirmed schedules for payroll
- Coordinated therapist to new clients
- Organized monthly meetings with therapist
- Assisted in medical records with filing & making charts
- Assisted in entering client information to data base
- Assisted in answering & transferring phone calls
- Communicated with clients & parents or guardians of pediatric patients
Customer Care Coordinator
Interim HealthCare
03.1996 - 03.2015
- PHC Supervisor Hired & Terminated caregivers
- Made home visits to our clients to supervise caregivers
- Confirmed time sheets for payroll
- Created schedules for caregivers and therapist
- Entered employees & clients information to data base
- Assisted in medical records with creating/discharge charts & filing
- Reviewed reports for payroll
- Assisted in answering & transferring phone calls to other departments
- Obtained benefits & authorization from BCBS, & FirstCare, United Healthcare for our nurses & therapist
- Entered client information to monitor client's vital signs that were submitted by Home Telehealth
Education
BrightStar
Lubbock, Texas04.2018
Interim HealthCare
Lubbock, Texas03.2015
CNA -
Lubbock, Texas08.1992
Medical Office Specialist -
IBC
Lubbock, Texas10.1987
High School Diploma -
Ralls, Texas05.1986
Skills
- Customer Service
- Hard Work Ethic
- Problem Solving
- Bilingual
- Dependable
- Honest
- EVV Training
- Prior authorization processing
- Insurance Verification
Personal Information
Gender: Female
Timeline
Authorization Specialist
Intrepid USA
03.2021 - Current
Staffing Services Coordinator
Girling Community Care
10.2019 - Current
Therapist Coordinator
Angels of Care
01.2019 - 09.2019
Outside Sales Representative
Lowe's
05.2018 - 07.2019
Therapist Coordinator
BrightStar
03.2015 - 04.2018
Customer Care Coordinator
Interim HealthCare
03.1996 - 03.2015
CNA
08.1992 - Current
Medical Office Specialist
IBC
10.1987 - Current
Interim HealthCare
CNA -
Medical Office Specialist -
IBC
High School Diploma -
BrightStar
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