Meylis Pena
Miami,FL
Summary
Proactive, goal-oriented professional experienced in time management and problem-solving. Delivered impactful contributions through reliability and adaptability, along with a swift capacity to learn and apply new skills. Focused on driving team success and contributing to organizational growth.
Overview
3
3
Languages
1
1
Certification
11
11
years of professional experience
Work History
Authorization Specialist
Medical Professionals of Miami
03.2026 - Current
- Obtain and manage prior authorizations for oncology treatments, chemotherapy, and related services
- Navigated and submitted prior authorization requests through Evolent, Availity, Starling Oncology, CovermyMeds, OncoHealth, and Prime Therapeutics to facilitate timely access to treatments
- Verify insurance eligibility, benefits, and coverage using Availity and other insurance portals
- Coordinate with physicians, nurses, and pharmacy staff to collect clinical documentation
- Communicate with insurance payers to resolve authorization issues
- Managed appeals and conducted peer-to-peer reviews for denied services to ensure appropriate authorization and patient care continuity
- Track authorization status and follow up on pending requests
- Enter and maintain accurate authorization and insurance data in EMR systems
- Ensure compliance with payer requirements, HIPAA, and internal policies
- Assisted patients in understanding insurance coverage and financial responsibilities to enhance clarity and support informed decision-making
- Give patient financial counseling on their out-of-pocket responsibilities and collect payments
Front Desk Supervisor/Authorization Specialist
Luis G. Diaz-Rangel, MD (Hematology/Oncology)
07.2015 - 02.2026
- Obtained pre-certifications and authorizations for chemotherapy IV treatments and chemotherapy oral treatments as well as other non-chemotherapy treatments.
- Coordinated with nursing staff and physicians to schedule chemotherapy IV treatments and non-chemotherapy treatments.
- Ensured patients felt comfortable and valued during their visits.
- Facilitated patient reception and managed appointment check-ins and check-outs.
- Scheduled appointments for office visits and treatments.
- Guided and assisted patients in the completion of necessary documentation.
- Verified insurance coverage using Availity and collected co-pays/co-insurances.
- Prepared patient charts for consultations and organized and requested necessary medical records.
- Took and recorded essential vital signs such as weight, height, blood pressure, pulse, and temperature.
- Managed high volumes of incoming calls and ensured timely responses to inquiries.
- Obtained necessary authorizations and referrals for consultations.
- Supported administrative tasks such as appointment scheduling, document scanning, filing charts, and faxing documents when necessary to maximize overall team productivity.
- Assisted in training new staff, sharing expertise and best practices for optimal performance.
- Conducted inventory checks and ordered supplies as needed.
- Ensured accurate data entry of patient information into electronic health record systems (EMR).
- Assisted physicians in physical examinations and translation for non-English speakers.
- Transcribed physician dictations of consultations into the EMR system accurately and efficiently.
- Coordinated medication refills by liaising with pharmacies.
Education
High School Diploma -
Hialeah-Miami Lakes Senior High School
Hialeah, FL05-2014
Skills
- Managing patient records/charting
- Pre-certifications
- Prior authorizations
- Insurance verification/eligibility
- Microsoft Office Suite
- Data entry
- Office management
- Medical terminology
- Bilingual
- Multi-line phone systems/triage
- Anatomy knowledge
- Time management
- Front desk
- Oncology
- Administrative support
- EHR/EMR management
- CPT/ICD-10 Coding
- Customer service
- Appointment scheduling
- Multi-tasking
- HIPAA/OSHA Compliance
- Medical transcription
- Attention to detail
- Vital Signs
Certification
Driver's License
Languages
Bilingual
English
Spanish - Expert
Personal Information
Driving License: Driver's License
Timeline
Authorization Specialist
Medical Professionals of Miami
03.2026 - Current
Front Desk Supervisor/Authorization Specialist
Luis G. Diaz-Rangel, MD (Hematology/Oncology)
07.2015 - 02.2026
High School Diploma -
Hialeah-Miami Lakes Senior High School