Marlene Astray-Caneda
Hialeah,FL
Summary
Detail-focused Insurance Verification Specialist recognized for high productivity and efficient task completion. Specialize in insurance policy verification, claim processing accuracy, and patient data confidentiality management. Excel in communication, problem-solving, and time management to ensure seamless operations within healthcare settings.
Overview
18
18
years of professional experience
Work History
Insurance Verification Specialist
Corrective Speech and Language Therapy
Kissimmee, FL
11.2022 - 03.2024
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Updated patient and insurance data and input changes into company computer system.
Secretary's Assistant
Forever Signs
Hialeah, FL
07.2019 - 11.2022
- Ensured that all customer service requests are handled in a timely manner.
- Answered telephones promptly and directed calls to appropriate personnel.
- Maintained office supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing orders for supplies; verifying receipt of supplies.
- Researched and responded to inquiries from customers regarding invoice status or payment history.
- Processed invoices in accordance to established procedures.
Checkout Assistant
GenesisCare
Hollywood, FL
11.2021 - 06.2022
- Verified patient coverage prior to appointment scheduling.
- Communicated with patients regarding their referral status, providing updates when necessary.
- Conducted outreach to community providers for referrals and resources.
- Monitored patient progress throughout the referral process.
- Managed daily patient referrals daily through multi-line telephone system.
- Scheduled patients according to availability, urgency and insurance authorization guidelines.
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
Referral Coordinator
Dr. Juan Abreu
Hialeah, FL
06.2018 - 04.2019
- Ensured compliance with HIPAA regulations when handling patient information.
- Assisted in the development of referral processes and procedures.
- Provided excellent customer service to both internal and external customers.
- Adhered to HIPAA regulations when handling confidential patient information.
- Resolved conflicts between referring physicians and receiving providers.
- Monitored patient progress throughout the referral process.
Front Desk Receptionist/Medical Referral Specialist
Dr. Pierre-Richard Edouard
Hialeah, FL
05.2012 - 06.2018
- Assisted with scheduling appointments for clients and visitors.
- Processed referrals for specialist care when requested by physicians or patients.
- Ordered office supplies as needed to maintain inventory levels.
- Answered incoming calls, responding to inquiries from patients and other medical offices.
- Greeted and checked in patients, updating patient information in computer system.
- Prepared charts for new patients, ensuring all necessary forms were completed correctly.
- Maintained confidentiality of patient information according to HIPAA regulations.
- Verified insurance coverage for appointments and collected co-payments as required.
Lead Operator
Mount Sinai Medical Center Of Florida
Miami Beach
07.2006 - 01.2012
- Oversaw staff schedules and assigned tasks according to workload requirements.
- Provided customer service support by responding to inquiries, complaints and requests for information.
- Verified caller identification before transferring calls or releasing confidential information.
- Maintained a clean work area by organizing supplies neatly throughout shift.
- Answered and transferred incoming calls to appropriate departments, personnel or outside lines.
- Handled confidential information with discretion and professionalism.
- Operated multi-line telephone system to answer incoming calls, determine purpose of callers, and forward calls to appropriate personnel or department.
Education
High School Diploma -
Miami Springs Senior High School
Miami Springs, FL06-1996
Skills
- Insurance terminology
- Medicaid knowledge
- Statement preparation
- Documentation and Correspondence
- Communication and Interpersonal Skills
- Customer Service
- Medical Terminology
- Insurance Coverage Verification
- Proficient EMR Therplan, EClinicals, Practice Fusion
- HIPAA Compliance
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
Insurance Verification Specialist
Corrective Speech and Language Therapy
11.2022 - 03.2024
Checkout Assistant
GenesisCare
11.2021 - 06.2022
Secretary's Assistant
Forever Signs
07.2019 - 11.2022
Referral Coordinator
Dr. Juan Abreu
06.2018 - 04.2019
Front Desk Receptionist/Medical Referral Specialist
Dr. Pierre-Richard Edouard
05.2012 - 06.2018
Lead Operator
Mount Sinai Medical Center Of Florida
07.2006 - 01.2012
High School Diploma -
Miami Springs Senior High School