MARIA GARCIA

Authorization specialist with 8 years of excellent written and communication skills to support a high volume in OTP and MAT authorization approval.

knowledge of all Los Angeles County and SAPC requirements.

• Confirm and update patient demographics, guarantor, and insurance information.
• Process all authorization request for Intakes and reauthorizations.
• Prepare and submit required documents for appeal approval.
• Obtain county c- number for new staff procedures and related services.
• Verify in PCNX realtime eligibility for all patient accounts.
• Respond to inquiries from SAPC Departments.
• Maintain, update and tracking all pending authorizations.
• Flag accounts for reauthorization
• Accurately assign ICD-10 diagnosis codes in PCNX
• Contact Clinic TCD and CS for any delays with documentation that can delays authorization process.
• Identify and report potential compliance risks and reimbursement opportunities.
• Collaborate closely with TCD, Counselors, PAR Billing Team and RDO staff.
• Demonstrate a strong sense of urgency to ensure timely authorization approvals.
• Perform additional duties as assigned.

• Manage day-to-day clinic operations, including but not limited to supervision of all clinic personnel.
• Ensures completion of all corrective actions plans in State, Federal, DEA, COA, and County.
• Implements a method system to prevent deficiencies maintaining confidentiality of both employees and patients’ files.
• Complete yearly employee evaluations, disciplinary action, and ensure personnel files are kept up to date.
• Create program goals that are constantly assessed and aligned in order to fulfill effective program events and objectives.
• Familiar with Title 9 DMC requirements and Los Angeles County Contract requirements.

• Review, maintain, and process fiscal/account records and transactions related to patient’s accounts.
• Verify insurance benefits, billing information, insurance coverage and estimated patient shares.
• Knowledge of SAPC/SAGE billing
• Maintain accurate accounts, i.e. required signatures, proper account annotation, current demographics, and correspondence.
• Maintains fiscal records and/or worksheets for all calculations, extensions, and verifications related to record keeping for assigned patient’s accounts.
• Contact patients for payment of account or payment arrangements according to current policy.
• Manage revenue cycle, production logs, balances and collections for self-pay clients.
• Maintain confidentiality of patient records.
• Monthly compliance audits
• Respond appropriately to requests for patient information. Auditing patient’s files and supervising counselors’ day to day work flow.

• Positioned at both locations, worked alongside with Medical Director and nurses to help provide quality care for substance abuse patients. Able to grasp quickly and efficiently procedures for Internal and Outside Audits.
• Work front and back office
• Performed data entry
• Obtaining vitals
• Collect urine specimens
• Insurance verification collecting and posting payments
• Answering phones in a professional manner
• Maintain confidentiality of patient records
• Filing medical and forms

• Coordinate multiple Doctors schedules from General Dentistry, to specialty Periodontist, Endodontist, Oral surgeon
• Responsible for billing dental insurance, posting payments, and claim estimations.
• Develops and maintains doctor/hygienist schedule to meet practice goals.
• Responsible for answering incoming calls to include, new patient calls, emergencies, scheduling patient appointments, requesting records, and follow up.
• Manage unscheduled list, re-call list, treatment-pending list, to ensure patient follow through to meet scheduling goals.
• Greet and check patients in and out for and after treatment.
• Practice Relations Coordinator. Managing referral sources. Increase and stimulate new patient growth by marketing to dentists.
• Tracking referral sources.
• Follows office procedures for patient referrals.
• Make pre-treatment financial arrangements with patients.
• Responds to doctor and patient concerns/inquiries and seeks assistance when necessary.
• General office duties and other duties as required