Reghan Resto
St Petersburg,FL
Summary
Knowledgeable in prior authorization within healthcare settings, handling tasks such as ensuring accuracy of patient insurance information and obtaining necessary approvals for medications, office visits, and advanced high-tech imaging. Exhibits strong skills in administrative work, documentation management, and encouraging effective communication between patients, providers, and insurance companies. Known for problem-solving capabilities, exactness in task completion and ability to positively impact workflow efficiency.
Overview
13
13
years of professional experience
Work History
Administrative Coordinator
Johns Hopkins All Children's Hospital
St. Petersburg, FL
01.2024 - Current
- Researched patient eligibility, coverage information, and benefit levels.
- Collaborated with insurance companies to clarify coverage details and resolve issues related to prior authorization.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Interpreted benefit language in order to determine covered services under each plan type.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
Patient Service Representative
Johns Hopkins All Children’s Hospital
St. Petersburg, FL
12.2019 - 12.2023
- Coordinated with clinical staff to manage patient flow, reducing wait times and improving satisfaction.
- Scheduled and confirmed patient appointments with healthcare professionals.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
- Answered incoming calls in a professional manner.
- Assisted with scheduling follow-up appointments according to provider availability.
- Processed insurance verifications and authorizations to ensure coverage of services.
Retail Sales
Torrid
St. Petersburg, FL
04.2018 - 03.2019
- Maintain knowledge of current sales and promotions, policies regarding payment and exchanges as well as security practices and procedures
- Provide excellent customer service with active listening to determine customer wants and needs
- Recommend, select, and help locate or obtain merchandise based on customer needs and desires
Assistant to CNA/ Cheer Team
Suncoast Hospice
St. Petersburg, FL
08.2013 - 06.2015
- Monitored patient condition by accurately attaining and documenting patient vital signs, observing physical and mental status, participation in exercise as well as nutritional ingestion and waste excretion
- Assisted family members in caring for the patient by teaching appropriate ways to lift, turn, and re-position the patient; advising on nutrition, cleanliness, and housekeeping
- Cared for patients by changing bed linens, washing and ironing laundry, cleaning, or assisting with their personal care
Office Receptionist Assistant
Brien E Pierpont MD, PA
St. Petersburg, FL
10.2011 - 07.2013
- Helped with making appointments, filing patient charts, inputting new patient demographics, incoming and outgoing faxes, answering phones
Education
Associate of Science Degree - Healthcare Management
Ultimate Medical Academy
01.2019
Diploma -
Boca Ciega High School
Gulfport, FLSkills
- Scheduling appointments
- Workload management
- Verbal and written communication
- Telephone etiquette
- File organization
- Team collaboration
- Attention to detail
- Benefit coverage
- Pharmacy benefit management
- Prior authorization process
- Insurance verification
- Electronic health records proficiency
- Professionalism and ethics
- Medical terminology knowledge
References
- Lakenyah Randall, (941) 280-8233
- Nickolina Vance, (727) 709-4739
- Corrie Parker, (727) 776-9571
Proficiencies
- Communication
- Computer literate
- Time management
- Attention to detail
- Teamwork
Timeline
Administrative Coordinator
Johns Hopkins All Children's Hospital
01.2024 - Current
Patient Service Representative
Johns Hopkins All Children’s Hospital
12.2019 - 12.2023
Retail Sales
Torrid
04.2018 - 03.2019
Assistant to CNA/ Cheer Team
Suncoast Hospice
08.2013 - 06.2015
Office Receptionist Assistant
Brien E Pierpont MD, PA
10.2011 - 07.2013
Associate of Science Degree - Healthcare Management
Ultimate Medical Academy
Diploma -
Boca Ciega High School
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