Noslen Morales
Miami,FL
Summary
Reliable professional offering an extensive career promoting positive customer experiences. Sharp Eligibility Specialist boasting expertise in managing and eligibility information for members and groups.
Overview
7
7
years of professional experience
Work History
Referral and Authorization Specialist
Caremax Medical Centers
Miami, FL
01.2021 - Current
- Researched patient eligibility, coverage information, and benefit levels.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Performed data entry into various computer systems including but not limited to EMRs and CRMs.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Reviewed authorization requests for accuracy and completeness.
- Monitored daily workflow queues within the department ensuring all tasks are completed accurately and timely.
- Provided customer service to internal and external customers related to authorization requests.
- Processed prior authorization requests in accordance with departmental guidelines.
- Created spreadsheets utilizing Microsoft Excel for tracking authorization status updates from payers.
- Conducted training sessions for new employees regarding company policies related to the authorization process.
- Supported onboarding of new employees by hosting orientation sessions.
Referral and Authorization Specialist
Face To Face Mental Health Services
Miami, FL
01.2019 - 12.2020
- Processed prior authorization requests in accordance with departmental guidelines.
- Generated monthly reports detailing productivity metrics such as number of authorizations processed per day, week, month.
- Collected, filed, scanned, and retrieved confidential patient information.
- Verified insurance information, collected payments, and scheduled appointments.
- Answered incoming calls in a professional manner.
- Scheduled patient appointments and procedures.
Phone Operator
Asthma & Allergy Associates
Miami, FL
03.2018 - 08.2018
- Answered calls in pleasant, calm voice and asked appropriate questions to direct callers to proper individuals.
- Greeted callers and identified their needs quickly and accurately.
- Maintained a professional demeanor while handling customer calls.
- Provided accurate information regarding company services, procedures, and policies.
- Answered incoming calls and directed them to the appropriate department or individual.
- Developed relationships with customers through effective communication techniques.
- Monitored system performance levels to ensure quality service was maintained at all times.
After School Care Leader
Miami Dade Public Schools
Miami, FL
02.2017 - 11.2017
- Kept areas clean, neat, and inspection-ready to comply with product guidelines.
- Coached and mentored individuals on professional development goals.
- Provided guidance and support to team members on operational issues.
- Ensured that all necessary health and safety protocols were being followed at all times.
Education
High School Diploma -
John A. Ferguson Senior High School
Miami, FLAssociate of Arts -
Broward College
Fort Lauderdale, FLSkills
- Claims Management
- HIPAA Compliance
- Insurance Verification
- Recordkeeping and Data Input
- Documentation and Paperwork
- Effective Communication Skills
- Telephone Etiquette
- Knowledgeable in Availity, NextGen, ICANotes, Lauris Online, Trinity, GoldMine, IMS software
- Knowledge using many insurance portals such as:
- United Healthcare
- Careplus
- CareCore
- AIM
- NIA
- Parachute Health
- Molina
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
Referral and Authorization Specialist
Caremax Medical Centers
01.2021 - Current
Referral and Authorization Specialist
Face To Face Mental Health Services
01.2019 - 12.2020
Phone Operator
Asthma & Allergy Associates
03.2018 - 08.2018
After School Care Leader
Miami Dade Public Schools
02.2017 - 11.2017
High School Diploma -
John A. Ferguson Senior High School
Associate of Arts -
Broward College