Sally Vasquez
St Cloud
Summary
Seeking a challenging role in a reputable organization to leverage problem-solving skills and enhance professional expertise. Proven ability to independently address complex issues and deliver optimal results. Committed to continuous personal and professional development.
Overview
18
18
years of professional experience
Work History
Authorization /Insurance Billing Specialist
New Life Heart Care
Orlando
07.2022 - 06.2025
- With proficient knowledge of ICD-10 and CPT codes of procedures and diagnoses, insurance guidelines, and medical terminology, I have proved patient and physician satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Calculate and collect copy, co-insurance, and deductible balances 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
Orlando
09.2021 - 06.2022
- Collaborated with healthcare providers to obtain the 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 the authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Analyzed medical records and other documents to determine the approval of requests for authorization.
- Input all patient data regarding claims and prior authorizations into the system accurately.
- Provided prior authorization support for physicians, healthcare providers, and patients in accordance with payer guidelines.
Medical Biller & Authorization Specialist
NYU Langone-CVA
Queens
09.2013 - 09.2021
- Scrub, submit, and communicate with insurance providers to resolve denied claims and resubmit.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Accurately entered and updated patient demographic and billing information, and posted insurance payments in the 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, radiology procedures, and surgery to be done in the office, hospital, and ambulatory center.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
Practice Billing Associate
NSLIJ-CVA
Queens
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 to 70 daily scheduled 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.
- Verified payments received from customers against outstanding invoices.
Medical Receptionist
North Shore
02.2007 - 08.2012
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Checked the patient's insurance, demographic information, and health history to keep the information current.
- Helped patients complete necessary medical forms and documentation.
- Coordinated patient scheduling, check-in, check-out, and payments for billing.
- Managed a 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, accurate medical records for patients.
- Kept the waiting room neat and organized by stacking magazines, removing trash, and cleaning the glass.
Education
High School Diploma -
NYC Brooklyn
New York, NYCPB - Certified Professional Biller
AAPC
Salt Lake, UTSkills
- 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 /Insurance Billing Specialist
New Life Heart Care
07.2022 - 06.2025
Prior Authorization and Insurance Specialist
Magruder Eye Ins
09.2021 - 06.2022
Medical Biller & Authorization Specialist
NYU Langone-CVA
09.2013 - 09.2021
Practice Billing Associate
NSLIJ-CVA
09.2012 - 08.2013
Medical Receptionist
North Shore
02.2007 - 08.2012
High School Diploma -
NYC Brooklyn
CPB - Certified Professional Biller
AAPC
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