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, CA07.2009
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