Summary
Overview
Work History
Education
Skills
Languages
Timeline
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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, FL

Associate of Arts -

Broward College
Fort Lauderdale, FL

Skills

  • 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

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Noslen Morales