SANDRA GARCIA
San Diego ,CA
Summary
Experienced in managing authorization processes and coordinating with medical teams, insurance providers, and patients. Strong skills in assessing patient eligibility for treatments, understanding policy coverage details, and ensuring compliance with healthcare regulations. Showcased ability to streamline workflows, improve system efficiency, and maintain high levels of accuracy in documentation. Proven record of enhancing patient satisfaction through diligent follow-up and timely resolution of queries.
Overview
18
18
years of professional experience
Work History
Authorization Coordinator
UCSD Health
San Diego, CA
07.2023 - Current
- Generated reports for management regarding the status of pending authorizations.
- Evaluated current policies and procedures related to authorizing services or products, making changes where appropriate.
- Maintained accurate records of all authorizations in the system.
- Assisted customers with questions or problems related to their authorization requests.
- Performed administrative duties such as filing, copying, scanning, faxing.
- Reviewed and approved authorization requests according to established criteria.
- Maintained confidentiality of patient information in compliance with HIPAA regulations.
- Obtained PA for services such as diagnostic imaging.
- Verified insurance eligibility for referred services using online databases and contacted insurers directly when needed.
- Updated patient accounts with insurance verification information to ensure accurate billing.
- Analyzed and interpreted insurance coverage policies to determine patient eligibility for services.
Patient Access Representative Perinatology
Rady Childrens Specialist of San Diego
San Diego, CA
10.2020 - 07.2023
- Applied knowledge of payer requirements, utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Verified demographics and insurance information to register patients in computer system.
- Applied HIPAA Privacy and Security Regulations while handling patient information.
- Scheduled patient appointment and procedures with EPIC.
- Coordinated between patients and healthcare professionals to meet patient needs.
- Registered patients by completing face-to-face interviews to obtain demographic, insurance, and other services.
Patient Service Representative Urgent Care
Sharp Rees-Stealy Medical Group
Chula Vista, CA
05.2019 - 05.2021
- Contributed to team meetings, sharing insights and strategies for improving patient access services.
- Processed referrals from primary care physicians to specialists for further treatment or evaluation.
- Processed patient co-pays, deductibles, and other payments, ensuring accurate financial records.
- Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
- Rounding on lobby making sure lobby is clean and safe.
- Screened employees and visitors using specific protocol and non-contact infrared thermometers.
- Documented and managed patient information using Centricity.
- Collaborated with other healthcare professionals to provide comprehensive patient care.
WIC Nutrition Assistant
SDSU Foundation W.I.C
San Diego, CA
05.2008 - 05.2019
- Efficiently handle administrative duties (e.g., answering phones, scheduling appointments, maintaining medical records and patient processing).
- Provide office administrative and clerical support, including handling confidential information.
- Perform data entry including dietary prescription changes for multiple family members.
- Individual and group education on a variety of general nutrition topics mostly related to nutrition in pregnancy, postpartum, infancy, and early childhood.
- Conducted 50 one-on-one counseling sessions per week.
Receptionist
San Diego County
San Diego, CA
03.2007 - 04.2008
- Provide excellent telephone, oral, and written support to maintain efficient operational processes in high-pressure environment.
- Duties included fielding telephone calls, receiving and directing visitors, word processing, filing and faxing.
- Provide assistance to management by composing correspondence and reports.
- Processed replies and incoming requests and put preliminary work play.
Education
High School Diploma -
University City High School
San Diego, California2005
ACCOMPLISHMENTS Certified as a WIC Nutrition Assistant -
Skills
- Authorization management
- Insurance verification
- Patient record management
- Reporting skills
- Team collaboration
- Customer service
- Workflow optimization
- Effective communication
- Attention to detail
- Strong communication skills
- Organizational growth
- Prior authorization
Languages
Spanish
Timeline
Authorization Coordinator
UCSD Health
07.2023 - Current
Patient Access Representative Perinatology
Rady Childrens Specialist of San Diego
10.2020 - 07.2023
Patient Service Representative Urgent Care
Sharp Rees-Stealy Medical Group
05.2019 - 05.2021
WIC Nutrition Assistant
SDSU Foundation W.I.C
05.2008 - 05.2019
Receptionist
San Diego County
03.2007 - 04.2008
High School Diploma -
University City High School