Summary
Overview
Work History
Education
Skills
Certification
Awards
Timeline
Generic

Tialisa Fernandez

Summary

Compassionate and detailed oriented in the medical field for 15 years in patient care. Specializing in Orthopedic Surgeries and Oncology.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Admin Rep Lead

UCSF Medical Center
01.2022 - Current
  • Communication with queries on the phone and by email, and communication expectations to employees
  • Training new staff, implementing UCSF policies
  • Preparing reports for morning huddles
  • Getting authorizations for RFI/Claim Edits on a daily basis
  • Oversee employees, communicating effectively to set priorities and expectations for each staff member
  • Excellent communication skills, resolve issues quickly by listening to concerns and collaborating with supervisors to find solutions.

Authorizations Representative Revenue Management

UCSF Medical Center
06.2019 - 01.2022
  • Reached out to insurance carriers to obtain prior authorizations for office visits or procedures
  • Obtained and logged accurate patient and demographic information for use by insurance providers
  • Fielded telephone inquiries on authorization details from plan members and medical staff
  • gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
  • Verified eligibility and compliance with authorization requirements for service providers
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures

Patient Financial Counselor

Stanford Hospital/Valley Medical Oncology Consult
06.2014 - 06.2019
  • Enhanced patient satisfaction by effectively explaining financial options and answering billing inquiries for patients that have Cancer.
  • Streamlined insurance verification processes for increased efficiency and reduced errors.
  • Discussed patients responsibility after insurance is billed, discussed copay and payment plans
  • I acted like a liaison between the insurance companies and patient.
  • Working with Pharmaceutical companies and other resources to obtain grants, financial aid, and free drugs for patients in need
  • Making and answering telephone calls from patients and insurance companies regarding the pre-certification process.

Medical Authorizations Specialist/Receptionist

Tracy Orthopedics
06.2009 - 06.2014
  • Developed strong relationships through consistent communication and attentive service for all patients.
  • Managing scheduling and organizing files
  • Working directly with patients to ensure their visits are optimal.
  • Worked the front desk and checked in patients, obtained copays, insurance cards and scheduling return appointments.
  • Answering phone calls and directing them to the correct dept
  • Keeping the front desk and office organized and running smoothly.
  • Contacting insurance companies for prior authorizations for surgeries.

Education

Administration Assist Manager - Medical

Institute of Technology
Modesto, CA
07.2009

Skills

  • Communication
  • Organization
  • Conflict resolution
  • Team builder
  • Strategic planner
  • Time management

Certification

Medical Administration Manager

Awards

Opening ceremony of DMV in Tracy, Honor Roll, Deans List, Perfect Attendance in College

Timeline

Admin Rep Lead

UCSF Medical Center
01.2022 - Current

Authorizations Representative Revenue Management

UCSF Medical Center
06.2019 - 01.2022

Patient Financial Counselor

Stanford Hospital/Valley Medical Oncology Consult
06.2014 - 06.2019

Medical Authorizations Specialist/Receptionist

Tracy Orthopedics
06.2009 - 06.2014

Administration Assist Manager - Medical

Institute of Technology

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Tialisa Fernandez