Prisma Hernandez
Spring,TX
Summary
Knowledgeable Provider Relations Representative offering more than 4 years of experience in field. Successfully optimizes services, resolves inquiries and reviews data quality. Diligent, reliable and determined to work hard, furthering my professional career. I strive to utilize strong prioritization and analytical ability to achieve the goals provided. Plan to use the best of my abilities to expand my knowledge while performing any job at its utmost level.
Overview
14
14
years of professional experience
Work History
Provider Relations Representative
Innovista Health Solutions
09.2019 - Current
- Strengthened provider networks through regular outreach and relationship building activities.
- Served as liaison between healthcare organizations and insurance companies to ensure seamless communication regarding claims processing and payment matters.
- Fostered strong, positive relationships with key providers.
- Collaborated with internal departments to resolve complex provider issues.
- Managed caseloads of dispute resolution cases, providing swift resolutions that maintained positive relationships with both parties involved.
- Brought in some new providers to enlarge network business.
- Answered provider inquiries/ concerns via email, telephone and face to face in timely manner.
Scheduling Coordinator, Authorization Specialist
ARTURO BRAVO MD.
09.2016 - 09.2019
- Utilized software tools like Excel, Outlook, and scheduling-specific platforms to effectively manage comprehensive appointment calendars.
- Scrutinize patient demographics and tracked data to monitor operational priorities and scheduling.
- Managed daily scheduling conflicts to reduce operational backlogs for office and place of service.
Receptionist
BEST ROW LAND & CLEARING INC.
02.2014 - 05.2016
Waitress/Cashier
TAQUERIA MICHOACAN MEXICAN RESTAURANT
01.2012 - 08.2013
Salesman/Cashier
THE DISTRICT CLOTHING STORE
10.2010 - 03.2012
Education
No Degree -
UNIVERSITY OF HOUSTON-DOWNTOWN
01.2022
High School Diploma -
ALDINE HIGH SCHOOL
01.2013
GRADUATED CERTIFIED COSMETOLOGIST
01.2013
Skills
Bilingual- Spanish/English
Self-initiative
Problem Solver
Managing Pressure
Critical Thinker
Communicative
Timeline
Provider Relations Representative
Innovista Health Solutions
09.2019 - Current
Scheduling Coordinator, Authorization Specialist
ARTURO BRAVO MD.
09.2016 - 09.2019
Receptionist
BEST ROW LAND & CLEARING INC.
02.2014 - 05.2016
Waitress/Cashier
TAQUERIA MICHOACAN MEXICAN RESTAURANT
01.2012 - 08.2013
Salesman/Cashier
THE DISTRICT CLOTHING STORE
10.2010 - 03.2012
No Degree -
UNIVERSITY OF HOUSTON-DOWNTOWN
High School Diploma -
ALDINE HIGH SCHOOL
GRADUATED CERTIFIED COSMETOLOGIST
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