Rina Lorena Lora Messeguer
Louisville,KY
Summary
Professional coordinator with deep expertise in managing authorization processes within healthcare settings. Skilled in navigating complex regulatory environments, ensuring compliance, and streamlining workflows. Strong emphasis on team collaboration and achieving high-impact results, adaptable to changing needs. Reliable problem-solver with focus on communication, organization, and patient advocacy.
Overview
12
12
years of professional experience
Work History
Prior Authorization Coordinator
Passport Health Plan by Molina Healthcare
12.2020 - 07.2024
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
- Reduced errors in documentation by meticulously reviewing medical records and verifying patient information.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Increased team efficiency by providing comprehensive training on prior authorization procedures for new hires.
- Verified eligibility and compliance with authorization requirements for service providers.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Adapted quickly to shifting priorities within the department, demonstrating flexibility and resiliency under pressure while remaining focused on achieving desired results.
- Streamlined communication between healthcare providers, pharmacists, and insurance companies to facilitate seamless patient care.
- Ensured compliance with state and federal regulations through diligent monitoring of prior authorization processes.
Pharmacy Technician
Hume Pharmacy
03.2017 - 12.2020
- Stocked, labeled, and inventoried medication to keep accurate records.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Provided exceptional customer service, fostering positive relationships with both new and returning patients at the pharmacy counter.
- Improved patient satisfaction by efficiently processing prescriptions and managing inventory in a timely manner.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Assisted in training new team members on standard operating procedures to ensure consistent quality of service across the entire team.
Pharmacy Technician
Park Duvalle Community Health Center
11.2015 - 03.2017
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Reduced medication errors by diligently cross-checking medications against patients'' profiles before dispensing.
- Supported inventory management initiatives through accurate record-keeping of received shipments and expired medications for disposal purposes.
- Streamlined prescription processing with accurate data entry and verification of patient information.
- Expedited insurance claim resolutions by liaising with healthcare providers and insurance companies on patients'' behalf.
- Managed medication inventory, ensuring availability of all necessary drugs.
Technician
Geek Squad
03.2013 - 11.2015
- Performed on site repair and preventive maintenance on personal computers and related peripherals
- Evaluated technical issues, solved customer concerns, and troubleshot computer problem in an efficient and courteous manners.
- Maintained meticulous records of maintenance activities, ensuring compliance with industry standards.
- Enhanced team productivity with thorough training on new technologies and procedures.
Intern
St Mary's Elizabeth Hospital
12.2012 - 01.2013
- Supported staff members in their daily tasks, reducing workload burden and allowing for increased focus on higher-priority assignments.
- Gained valuable experience working within a specific industry, applying learned concepts directly into relevant work situations.
- Sorted and organized files, spreadsheets, and reports.
- Gained hands-on experience in various software programs, increasing proficiency and expanding technical skill set.
- Provided exceptional customer service by promptly addressing inquiries, ensuring a high level of satisfaction among clientele.
Education
Associate Degree - Pharmacy Technician
National College
Louisville, Kentucky05.2014
Skills
- Pharmacology
- Documentation expertise
- Medical terminology knowledge
- Data entry proficiency
- Insurance Verification
- Effective communication skills
Training
St Mary’s & Elizabeth, Louisville, KY, Pharmacy Technician Extern, 12/12 - 01/13, Completed 120 hours externship., Print and labeling bags, Count and measure out medications, Stock and rotate shelves, Use the correct aseptic procedures and add mixtures, Stock medicine carousel
Coursework
- Dosage & Calculations
- Introduction to Pharmacology
- Pharmacy System of operation
- Pharmacy Practice
- Health Care Law and Ethics
Languages
Spanish
Native or Bilingual
English
Full Professional
Timeline
Prior Authorization Coordinator
Passport Health Plan by Molina Healthcare
12.2020 - 07.2024
Pharmacy Technician
Hume Pharmacy
03.2017 - 12.2020
Pharmacy Technician
Park Duvalle Community Health Center
11.2015 - 03.2017
Technician
Geek Squad
03.2013 - 11.2015
Intern
St Mary's Elizabeth Hospital
12.2012 - 01.2013
Associate Degree - Pharmacy Technician
National College
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