Sally Vasquez
St Cloud,Florida
Summary
To secure a challenging position in a reputable organization for expansion of personal skills, knowledge and experience. Demonstrated to solve problems independently and perform at an optimal level.
Overview
17
17
years of professional experience
Work History
Authorization and Insurance Specialist
New Life Heart Care
07.2022 - Current
- With proficient knowledge of ICD-10 and CPT codes of procedures and diagnosis , insurance guidelines and medical terminology has proved patient and physician satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Calculate copy, co insurance and deductible for all visits and diagnostic testing.
- Processed eligibility and benefits verification, referrals and authorization requests.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
Prior Authorization and Insurance Specialist
Magruder Eye Ins
09.2021 - 05.2022
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Reduced processing times by effectively managing 50 to 60 authorizations and referrals daily.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
Medical Biller & Authorization Specialist
NYU Langone-CVA
09.2013 - 09.2021
- Scrub, Submit and communicated with insurance providers to resolve denied claims and resubmitted.
- Verified and update insurance over 20 patients insurance eligibility daily.
- Collected payments and post EOB and insurance payment to patients account
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Accurately entered and update patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Reviewed patient diagnosis codes to verify accuracy and completeness to obtain cardiac authorization for all diagnostic and radiology procedures and surgery to be done in office, hospital and ambulatory center.
Practice Billing Associate
NSLIJ-CVA
09.2012 - 08.2013
- Streamlined invoicing process for increased efficiency, utilizing automated billing software and systems.
- Maintained updated records of customer account information to ensure accurate and timely billing processes for 50 -70 daily schedule patients
- Enhanced client satisfaction by promptly addressing and resolving billing inquiries, discrepancies, or disputes.
- Ensured compliance with company policies and industry regulations while managing sensitive financial data securely .
Head Teller
Marathon Bank
10.2008 - 02.2012
- Verified amount of cash in cash drawer against day's receipts, quickly identifying errors.
- Replenished ATM funds in empty canisters prior to validation process.
- Answered inquiries regarding checking and savings accounts and other related products.
- Completed highly accurate, high-volume money counts via both manual and machine-driven approaches.
- Created teller schedule to keep weekly and weekend shifts properly staffed.
- Identified potential needs through observation, questioning, and listening
- Introduced customers to other bank team members to help meet financial needs and maintaining 10% quotes weekly.
- Received car loan, home loan, and other payments and posted to accounts.
Medical Receptionist
North Shore
02.2007 - 09.2008
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Managed multi-line phone system for 13 physicians and pleasantly greeted patients.
- Organized paperwork such as charts and reports for office and patient needs.
- Maintained current and accurate medical records for patients.
- Kept waiting room neat and organized by stacking magazines, removing trash, and cleaning glass.
Education
GED -
NYC Brooklyn GED School
New York, NYSkills
- Documentation Abilities
- Reporting Abilities
- Reporting Skills
- Documentation Skills
- Account Management
- Regulatory Compliance
- Insurance Law Knowledge
- Problem Solving
- Interpersonal Skills
- Fraud Detection
- Empathy and Understanding
- Customer Service
- Decision Making
- Data Analysis
Timeline
Authorization and Insurance Specialist
New Life Heart Care
07.2022 - Current
Prior Authorization and Insurance Specialist
Magruder Eye Ins
09.2021 - 05.2022
Medical Biller & Authorization Specialist
NYU Langone-CVA
09.2013 - 09.2021
Practice Billing Associate
NSLIJ-CVA
09.2012 - 08.2013
Head Teller
Marathon Bank
10.2008 - 02.2012
Medical Receptionist
North Shore
02.2007 - 09.2008
GED -
NYC Brooklyn GED School
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