STEPHANIE MELENDEZ
Worcester,MA
Summary
To obtain a position using my customer service experience. Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows.
Overview
8
8
years of professional experience
Work History
Prior Authorization Specialist
Complete Staffing Solutions
Worcester, MA
08.2022 - Current
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Tracked referral submission during facilitation of prior authorization issuance.
- Answered average of calls, emails and faxes per day, addressing patient inquiries, solving problems and providing/obtaining authorization information.
PHYS PRACTICE COORDINATOR
Saint Vincent Physcians Services
Worcester, Ma
08.2019 - 08.2022
- Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing
- Successfully scheduled patient appointments and placed reminder calls to deliver exceptional customer experience
- Completed and filed financial documentation for accounting purposes
- Organized paperwork such as charts and reports for office and patient needs
- Improved timely payment of bills by developing flexible payment plans for patients
- Supported providers in outpatient medical office through coordinating all administrative operations
- Received, recorded and addressed incoming and outgoing communication via telephone and email
- Coordinated front office duties, including customer service, patient scheduling and billing
- Verified insurance benefits or eligibility
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
MEDICAL ASSISTANT
Reliant Medical Group
Worcester, MA
01.2015 - 08.2019
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions
- Maintained detailed records of test results by entering data and patient information into computer
- Updated inventory, expiration and vaccine logs to maintain current tracking documentation
- Oriented and trained new staff on proper procedures and policies
- Prepared patients for X-rays, electrocardiograms, suture removal and dressing changes
- Communicated clearly and effectively with patients to verify information, determine purpose of visit and record medical history
- Implemented care and efficiency improvements to support and enhance office operations
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted
- Collaborated with medical and administrative personnel to maintain patient- focused, engaging and compassionate environment
- Conducted preliminary evaluations, including measuring weight, temperature and blood pressure, and documented results with accuracy
- Sanitized, restocked and organized exam rooms and medical equipment
- Obtained client medical history, including medication information, symptoms and allergies
- S
- M
Education
MEDICAL ASSISTANT CERTIFICATE -
and Chester
HIGH SCHOOL DIPLOMA - undefined
Worcester Technical High School
Skills
- Insurance Verification
- Medical terminology
- Customer service
- Team building
- Organization
- Problem resolution
Timeline
Prior Authorization Specialist
Complete Staffing Solutions
08.2022 - Current
PHYS PRACTICE COORDINATOR
Saint Vincent Physcians Services
08.2019 - 08.2022
MEDICAL ASSISTANT
Reliant Medical Group
01.2015 - 08.2019
MEDICAL ASSISTANT CERTIFICATE -
and Chester
HIGH SCHOOL DIPLOMA - undefined
Worcester Technical High School
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