Thalia Ortiz
Orlando,FL
Summary
Experienced professional with 8+ years of industry expertise. Demonstrated ability to excel in various roles, consistently delivering exceptional results. Proven track record of successfully managing projects and teams, ensuring timely completion and exceeding client expectations. Skilled in problem-solving and strategic thinking with a keen eye for detail. Seeking new opportunities to leverage extensive experience and contribute to the success of a dynamic organization.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Practice Transitions- Project Manager
AdventHealth Medical Group
04.2024 - Current
- Successfully established clear project scope and objectives
- Develop detailed project plans, including timelines, milestones, and resource allocation for new practice locations and relocations
- Identify and manage project dependencies and critical paths for new AHMG practices
- Oversaw the organization and direction of project teams, delegating tasks and responsibilities
- Established an atmosphere of collaboration and productivity within the team
- Ensured team members received the necessary guidance and support to excel in their roles.
- Ensure all project deliverables are completed, approved, and set to go live on deadline dates
- Facilitated project closure meetings and reviews.
HR Provider Onboarding Coordinator
AdventHealth Medical Group
08.2021 - 09.2023
- Facilitated teamwork between Managed Care and Medical Staff Credentialing teams leading to effective provider credentialing with government payors and attainment of hospital privileges
- Effectively communicated all project issues or challenges to the Support Manager, Managed Care Liaison, or Patient Accounting Director
- Streamlined the process of scheduling employee health screenings and coordinating onboarding appointments by efficiently engaging with providers, sending reminders, and closely collaborating with local HR.
- Enhanced efficiency of the onboarding processes within the medical group project through effective communication between providers and AHMG's payroll, compensation, and medical staff teams.
- Adhere to and meet project-specific deadlines, fostering collaborative interactions with cross-functional departments, facility HR, Hiring Managers, and Employees, demonstrating respect and diligence throughout the project lifecycle.
- Conducted regular meetings with department heads to discuss progress of newly onboarded employees and identify areas for improvement.
Billing Account Rep I- Commercial/Auto Denials Billing (Revenue Cycle)
AdventHealth
01.2020 - 08.2021
- Collects, analyses and reports data for insights into the denials management operations business and for special prevention and denials management projects
- This includes identifying denial trends by root cause, payor related issues, physician, etc
- Reviews error reports from electronic payers; identifies errors and makes appropriate corrections to ensure accurate claim submission
- Maintains system work queues based on electronic payers' error reports as assigned including but not limited to DNB, Claim Edits, Front End Rejections, and No Response from payers
- Responsible for account follow-up for all assigned accounts.
Insurance Authorization Representative (Revenue Cycle)
AdventHealth
02.2018 - 01.2020
- Obtains insurance authorization with government payors (Cigna, UHC, Medicare, Medicaid)
- Contact insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and claim information
- Ensure specified medical terms, diagnosis, medication codes and supporting clinical documentations are met.
Receptionist- Full time
AdventHealth Imaging
08.2016 - 02.2018
- Serves patients by greeting, welcoming and directing them appropriately
- Keeps a safe and clean receptionist area by complying with procedures, rules, and regulations
- Contributes to team effort by accomplishing related results as needed
- Completed registration face to face in a timely manner
- Collected copays and managed a cash drawer
- Schedule and reschedule patient appointments
- Conduct training and mentor new hires.
Education
BACHELOR IN SCIENCE -
HEALTH SCIENCES- SEMINOLE STATE COLLEGE
ASSOCIATES DEGREE -
VALENCIA COLLEGE
12.2020
Skills
- Project Management
- Project Planning
- Project planning and development
- Project Scheduling
Certification
Lean Six Sigma- Green belt
Timeline
Practice Transitions- Project Manager
AdventHealth Medical Group
04.2024 - Current
HR Provider Onboarding Coordinator
AdventHealth Medical Group
08.2021 - 09.2023
Billing Account Rep I- Commercial/Auto Denials Billing (Revenue Cycle)
AdventHealth
01.2020 - 08.2021
Insurance Authorization Representative (Revenue Cycle)
AdventHealth
02.2018 - 01.2020
Receptionist- Full time
AdventHealth Imaging
08.2016 - 02.2018
BACHELOR IN SCIENCE -
HEALTH SCIENCES- SEMINOLE STATE COLLEGE
ASSOCIATES DEGREE -
VALENCIA COLLEGE
Lean Six Sigma- Green belt
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