SABRINA RODRIGUEZ
Georgetown,USA
Summary
Experienced with navigating healthcare insurance systems to secure treatment approvals. Utilizes keen attention to detail and extensive knowledge of medical terminology to streamline processes. Strong understanding of insurance guidelines and patient advocacy to ensure optimal outcomes.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Medication Prior Authorization Specialist
Premier Family Physicians
10.2020 - 10.2024
- Managed prior authorization requests, ensuring compliance with insurance guidelines and medical necessity criteria.
- Coordinated communication between healthcare providers and insurance companies to expedite processing of authorizations.
- Reviewed clinical documentation for accuracy and completeness to support prior authorization submissions.
- Trained new staff on procedures for submitting prior authorization requests and using relevant software tools.
- Analyzed trends in authorization denials, recommending solutions to minimize future occurrences and enhance approval rates.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Improved patient satisfaction with timely and accurate processing of prior authorizations for medications
- Maintained up-to-date knowledge of changing healthcare regulations and insurance policies to ensure accurate processing of requests.
- Assisted in development of educational materials for patients and providers about prior authorization process.
Medical Assistant
Aspire Allergy and Sinus Centers
03.2019 - 04.2020
- Educated patients on physicians orders and how to administrate therapy at home.
- Conducted allergy testing and assessed patient reactions to various allergens.
- Ensured accuracy in test results by properly documenting patient information and test outcomes in electronic medical records systems.
- Cleaned and sterilized instruments, equipment and surfaces.
- Collaborated with healthcare professionals to develop personalized allergy management plans.
- Trained new staff on allergy testing protocols and safety procedures.
- Maintained inventory of allergen supplies, ensuring timely availability for clinical operations.
- Developed strong relationships with patients by providing empathetic care and support throughout the allergy testing process.
- Increased patient satisfaction by addressing concerns and answering questions related to allergy testing procedures.
- Performed comprehensive diagnostic assessments using advanced imaging techniques such as CT scans for accurate diagnoses.
- Conducted regular assessments of patients' lung function using spirometry tests.
- Coordinated with care teams across various departments to ensure seamless integration of verified coverage information into overall treatment planning.
- Reduced patient wait times by optimizing clinic scheduling procedures.
Medical Assistant Team B- Lead
COMMUNITY CARE MOBILE TEAM
09.2017 - 02.2019
- Coordinated patient care services for diverse populations in outreach settings.
- Assisted healthcare providers with clinical procedures and patient examinations.
- Managed scheduling and documentation to ensure efficient workflow within mobile team operations.
- Trained new staff on best practices for community outreach and patient assessment techniques.
- Conducted health education sessions, promoting disease prevention and wellness among underserved populations.
- Obtained client medical history, medication information, symptoms, and allergies.
- Performed medical records management, including filing, organizing and scanning documents.
- Maintained a safe and clean clinical environment by adhering to infection control guidelines and disposing of biohazardous waste properly.
- Boosted patient satisfaction by providing compassionate care and promptly addressing needs during visits.
- Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
- Enhanced team communication by organizing regular staff meetings and sharing updates on patient care protocols.
Education
Associate of Arts - Business
Liberty University
Lynchburg, VA12-2025
Certificate - Medical Assistant
Virginia College of Austin
Austin, TX12-2017
Skills
- Medical appeals handling
- Insurance verification
- Electronic health records proficiency
- Medical terminology knowledge
- Process improvement strategies
- Workflow management
- Proficiency in Athena and EPIC EHR systems
- Multitasking
- Appointment scheduling
- HIPAA compliance
- Patient-focused care
Certification
Certified Medical Assistant
Timeline
Medication Prior Authorization Specialist
Premier Family Physicians
10.2020 - 10.2024
Medical Assistant
Aspire Allergy and Sinus Centers
03.2019 - 04.2020
Medical Assistant Team B- Lead
COMMUNITY CARE MOBILE TEAM
09.2017 - 02.2019
Associate of Arts - Business
Liberty University
Certificate - Medical Assistant
Virginia College of Austin