Teresa Pardo
Kyle,TX
Summary
Professional in healthcare industry, bringing valuable experience in authorization management and compliance. Known for delivering reliable and timely authorizations while maintaining robust communication with healthcare teams. Consistently focused on collaborative efforts and achieving results, ensuring organizational goals are met. Skilled in problem-solving and adaptable to changing requirements.
Overview
9
9
years of professional experience
Work History
Authorization Specialist II
Centene Corporation
01.2022 - Current
- Track and maintain Inpatient and Outpatient authorization requests for services in accordance with the insurance prior authorization list and route to the appropriate clinical reviewer
- Provide some guidance and support of the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
- Back up Team Lead assist with aging reports and audits, review escalations. Reporting on authorization volumes and alignment on staffing assignments
- Preceptor providing trainings to learn Ambetter process. Act as a subject matter expert to team members for the overall authorization process and for multiple service types at different levels of urgency
- Performing other duties as assigned flexibility on work schedules and assignments cross trained and worked with (Medicaid Florida, Medical Records, Turning Point, and Claims)
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
Vertexer
Burnett Staffing / Centene Corporation
01.2020 - 01.2022
- To accurately enter data from incoming medical forms into assigned software packages.
- Corrects entries where indicated and maintains appropriate records, files, documentation, etc
- Backup team lead when needed assisting in sending hourly production reports and to assist team with questions or problems they may be experiencing
- Self-motivated, with a strong sense of personal responsibility.
- Passionate about learning and committed to continual improvement. Cross train in other departments to assist when needed to keep volume down.
Rideshare Driver
Lyft Rideshare
03.2019 - 03.2020
- Company Overview: Lyft is an online platform that matches drivers with passengers
- Maintained high customer service rating
- Developed strong communication skills while interacting with diverse groups of riders daily.
Payroll Specialist III
Austin ISD
05.2016 - 06.2018
- Manage Payroll workflow to ensure all transactions are processed accurately and timely
- Review, edit, and reconcile payroll with various reports prior to payroll run. Reports included are timeoff request, benefits distribution, supplemental pay
- Assisted employees with inquiries regarding their paychecks, deductions, and other related issues, providing clear and concise communication.
- Input necessary information such as child support, additional withholding, garnishments for miscellaneous deductions set up employees on payment plans for reimbursements to the company when necessary
Education
Accounting/ Bookkeeping Series Certificate - Accounting, Financial Statements Analysis, Computerized Accounting (QuickBooks), Business Tax Forms
Austin Community College
Austin, TX05.2019
Skills
- Insurance verification ,
- Medical terminology expertise
- Data entry proficiency
- Backup Team Lead, Preceptor
Traits
- Dependable, Hardworking, Flexible
- Great work ethic
- Ability to work independently
- Leader
Timeline
Authorization Specialist II
Centene Corporation
01.2022 - Current
Vertexer
Burnett Staffing / Centene Corporation
01.2020 - 01.2022
Rideshare Driver
Lyft Rideshare
03.2019 - 03.2020
Payroll Specialist III
Austin ISD
05.2016 - 06.2018
Accounting/ Bookkeeping Series Certificate - Accounting, Financial Statements Analysis, Computerized Accounting (QuickBooks), Business Tax Forms
Austin Community College
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