Nicole Quintal
Authorization Specialist
Immokalee,FL
Summary
Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Professional with skill to maintain accurate records, insurance eligibility and handle various administrative responsibilities. Astute medical administrative professional trained in obtaining authorizations for procedures in and out patient . Helps staff maintain office operations at optimal levels with great organizational and multitasking abilities.
Overview
36
36
years of professional experience
Work History
Sr. Financial Specialist
Mt. Sinai Hospital
08.2010 - 12.2022
- Reviewing and Analyzing patients charts to obtain authorizations for outpatient and inpatient procedures in Epic
- Responsible for insurance verification for all encounters for both hospital and physician
- Managed 50 patients per day
- Reduced denial rate by 95 % by securing authorizations
- Referral coordination
- Accurately calculated patient’s payment responsibility
- Obtaining authorization and benefits screening through Insurance Portal
- Pre-registering Patients into Cerner System
- Processing Payments and Billing Patients for uncovered charges
- Following up with patients on Insurance Information
- External agencies) and took appropriate action
- Worked with external agencies to resolve open issues regarding accounts balances.
FGP Assistant
Mt. Sinai Hospital
08.2010 - 12.2022
- Financial screening for outpatient services. Verifying benefits, eligibility and authorizations. Advising patients of responsibility copays deductibles before patients visit.
- Decreased insurance denial rate by 95% by securing authorizations through Insurance Portal or calling in to UM Dept. in a timely manner.
- Managed over 45 patients per day.
- Reduced patient complaints by being primary point of contact for and liaison between patients, administrative staff and physicians to facilitate proper lines of communication and expedite problem resolutions
- Worked alongside Biller and Surgical Coordinator to provide the best care to patients
- Initiated contact with insurance companies to investigate or resolve payer/edit issues and follow up with pending authorizations before pts scheduled visit.
- Coordinated multiple office functions that focus on computerized scheduling, electronic billing accounts payable/receivable, Electronic Medical Record and payment plans with a demonstrated knowledge of insurance carriers and medical terminology
- Trained employees on how to use the EPIC program and enter patient’s demographics in the system.
Operations Representative
Double Rock Corporation
04.1999 - 12.2010
- Delegated work and coordinated staff members' daily responsibilities
- Process stop payments request
- Analyze and reissue visa debit cards on a monthly basis
- Process lost/stolen forms
- Settled daily debit/credit of money movements/ wire transfers
- Daily balancing of debit/credit portfolio ledgers
- Processed and manually order visa debit cards and ran credit reports
- Fraud prevention on visa cards
- Process ACH applications
Education
Certificate in Applied Management/ Medical Administrative - Billing And Coding
PENN FOSTER COLLEGE, York
Online06.2009
High School Diploma -
Pleasantville Senior Comprehensive School
Trinidad And Tobago08.1990
Skills
- Computer Skills:
- EPIC; Eagle; Cerner; Passport; Ontrac Microsoft Office (Word, Excel, Outlook), Lotus Notes, Data Entry,
- Power Point, Typing Skills: 75 words/min, Lytec Software, E Z Claim Software; Cerner
- Navigating Insurance authorization portals
Timeline
Sr. Financial Specialist
Mt. Sinai Hospital
08.2010 - 12.2022
FGP Assistant
Mt. Sinai Hospital
08.2010 - 12.2022
Operations Representative
Double Rock Corporation
04.1999 - 12.2010
Certificate in Applied Management/ Medical Administrative - Billing And Coding
PENN FOSTER COLLEGE, York
High School Diploma -
Pleasantville Senior Comprehensive School
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