Stephanie Lozano
Chicago,IL
Summary
Prior authorization specialist with a strong background in insurance verification and problem-solving at Lawn Medical Center. Demonstrated success in securing authorizations and improving patient care through clear communication. Bilingual in English and Spanish, proficient in Epic software, and dedicated to maintaining HIPAA compliance.
Overview
13
13
years of professional experience
Work History
Prior Authorization Coordinator
Lawn Medical Center, S.c
Oak Lawn, Minois
04.2025 - 12.2025
- Coordinated issue resolutions and appealed denied authorizations to facilitate timely patient access to necessary services.
- Processed prior authorization requests for various medical services and procedures.
- Communicated with insurance companies to verify coverage and authorization status.
- Applied knowledge of Medicare, Medicaid, and third-party payer requirements utilizing online eligibility systems to verify patient coverage and policy limitations.
- Reviewed clinical documentation for accuracy and completeness to ensure successful authorization submissions.
- Collaborated with healthcare providers to gather necessary patient information.
- Maintained detailed records of authorization requests and communications.
- Educated patients on prior authorization requirements and timelines to enhance understanding and compliance.
- Scheduled patient appointments, diagnostic specialty appointments, tests, and procedures.
Prior Authorization Specialist
Loyola University Medical Center
Maywood, IL
01.2019 - 12.2024
- Compiled and submitted precertification requests, ensuring timely review by payers.
- Secured prior authorization for therapy services, facilitating patient access to necessary treatment.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Assisted with answering provider inquiries regarding preauthorization requirements and processes.
- Demonstrated expertise in Epic and Evicore systems for enhanced workflow efficiency.
- Achieved proficiency in OneSource, Availity, RadMD, and Cohere platforms.
- Analyzed denial trends to identify and address issues in authorization processes.
- Resolved any discrepancies identified during the precertification process.
- Obtained Worker Comp approvals to streamline claims processing.
- Applied knowledge of Department of Labor regulations to ensure compliance.
- Coached new associates on various systems and best practices for Insurance verification.
Optician
Sam's Club Optical
Tinley Park, IL
10.2012 - 01.2019
- Entered data into systems, ensuring accuracy of patient records. to maintain up-to-date records efficiently.
- Verified insurance benefits, facilitating access to necessary patient care.
- Scheduled and confirmed appointments to enhance patient flow.
- Organized patient prescriptions, doctor files, and sales sheets for streamlined access.
- Promptly resolved customer inquiries via phone, ensuring accurate responses and enhancing satisfaction.
- Managed cash transactions, maintaining accountability and precise financial reporting.
- Balanced register daily for accurate financial record-keeping.
- Ensured confidentiality by adhering to HIPAA regulations during all interactions.
Education
High School Diploma -
Hubbard High School
Chicago, IL06-2009
Skills
- Insurance verification
- CPT coding knowledge
- ICD-10 familiarity
- Epic software
- Team collaboration
- Customer service
- Phone etiquette skills
- Bilingual communication
- Patient care techniques
- Retail sales experience
Languages
Professional, Professional
Timeline
Prior Authorization Coordinator
Lawn Medical Center, S.c
04.2025 - 12.2025
Prior Authorization Specialist
Loyola University Medical Center
01.2019 - 12.2024
Optician
Sam's Club Optical
10.2012 - 01.2019
High School Diploma -
Hubbard High School