Summary
Overview
Work History
Education
Skills
Timeline
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Viviana Saez

Summary

Reliable and detail-oriented administrative professional with strong experience in fast-paced healthcare and customer service environments. Skilled in handling patient records, scheduling, insurance verification, and front desk operations while delivering compassionate and efficient support to patients and staff. Known for excellent communication, problem-solving abilities, and a commitment to confidentiality and quality care. Thrive both independently and as part of a team, maintaining professionalism and accuracy under pressure.

Overview

14
14
years of professional experience

Work History

Third Key Manager

Fossil Outlet Store
09.2024 - Current
  • Observe and coach the team to deliver an exceptional store experience and build brand loyalty. Provide outstanding customer service, handle inquiries, and resolve issues effectively.
  • Align daily activities with business needs to achieve sales goals and contribute to overall store performance. Motivate and inspire team members through a team-centric leadership approach, creating a positive work environment.
  • Assist with daily operations including opening and closing procedures, cash handling, and adherence to operational policies. Maintain visual merchandising standards and ensure a clean, organized store environment.
  • Support the onboarding and development of team members by providing timely and constructive feedback. Train new employees on company procedures and policies.
  • Supervised daily operations, ensuring efficient workflow and adherence to company standards.
  • Collaborated with management to develop strategic initiatives for enhancing store performance.

Revenue Integrity Specialist

HCA Healthcare, Inc. - Parallon
09.2023 - Current
  • Review daily charges to ensure expected total charge variations balance to maintain revenue neutrality.
  • Collaborates with revenue generating department leaders prior to and post go-live to determine what charging practices will change and where charges will move to.
  • Monitors daily ancillary charge report and other data analytic tools to identify total charge and potential net revenue variations.
  • Monitors revenue and usage reports outlining charges posted and non-usage of charge master lines to determine if revenue is being lost.
  • Performs root cause analysis on identified total charge variations and collaborates with the Revenue Integrity Clinical Analysts and/or Facility Director to resolve identified issue.
  • Monitors total charges associated with new service lines, procedures and/or systems to ensure charges are crossing through the various systems to Patient Accounting.
  • Reconciles charging based on swings in gross charges, monitor changes are in compliance with standardized HCA and regulatory requirements.
  • Consistently monitors charging practices that impact total charges across HCA facility.
  • Works on Charge Optimization projects when time permits and support the Corporate RI team when necessary on special projects.
  • Analyzed billing discrepancies to enhance revenue cycle accuracy.
  • Implemented compliance protocols to ensure adherence with regulatory standards.

Insurance Verification Coordinator

HCA Healthcare, Inc. - Parallon
06.2022 - 09.2023
  • Verified client information by analyzing existing evidence on file.
  • Determined appropriateness of payers to protect organization and minimize risk.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Updated patient records with accurate, current insurance policy information.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Communicated verification and status updates with home health agencies to facilitate decision-making for patient admissions and insurance coverage.
  • Coordinated insurance verification processes to ensure timely patient eligibility determinations.
  • Streamlined documentation procedures, improving accuracy of patient records and billing information.

Prior Authorization Coordinator

HCA Healthcare, Inc. - Parallon
03.2020 - 06.2022
  • Tracked referral submissions during facilitation of prior authorization issuance.
  • Input all patient data regarding prior authorizations into system accurately.
  • Reached out to insurance carriers to obtain prior authorization for home health services.
  • Analyzed medical records and other documents to determine approval of requests for authorization.
  • Researched denied claims and contacted insurance companies to resolve these issues.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Processed prior authorization requests efficiently, ensuring compliance with healthcare regulations.
  • Collaborated with healthcare providers to gather necessary documentation for approval.

Customer Service Representative

HireRight
04.2019 - 02.2020
  • Responded to client and applicant calls, emails, and chats to answer questions about background check status.
  • Handled customer inquiries and suggestions courteously and professionally and escalated major issues to supervisor.
  • Utilized customer service software (Salesforce) to manage interactions and track customer satisfaction.
  • Trained new personnel regarding company operations, policies and services.
  • Obtained background check data on characters, financial statuses and personal histories.
  • Conducted comprehensive interviews with subjects, employers, associates, references and other individuals.

Intake & Staffing Coordinator

Caring Home Care
02.2018 - 04.2019
  • Assessed clients' needs and determined eligibility for intake services.
  • Enter and discharge patients into system, creating new patient charts and upload client documentation.
  • Staff and schedule cases for clients and keep up with schedule modifications and changes.
  • Receive, enter, and upload all incoming authorizations from Insurance Carriers.
  • Assist with On-Call after hours and weekends as needed.
  • Travel to other branch office locations to assist with implementation training on system or employee coverage.
  • Assist Human Resources with new onboarding CNA and HHA workers and yearly updates for existing workers.
  • Communicated with people from various cultures and backgrounds on application process.
  • Selected qualified applicants to refer to clients for possible job placement.

Intake & Staffing Coordinator

Maxicare Select, Inc
07.2015 - 01.2018
  • Assessed clients' needs and determined eligibility for intake services.
  • Completed intake assessment forms and filed clients' charts.
  • Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
  • Staff and schedule skilled cases with disciplines needed (SN, PT, OT, ST, HHA, CNA, etc.) for each patient.
  • Upload patient care related documentation and doctors orders into the system as they become available.
  • Assist with payroll by confirming and submitting Sub Contractor invoices and employee timesheets into the system.
  • Follow up weekly with MD offices to send and obtain POC's/POT's for patient 485 documentation needed.
  • Maintain communication with Case Managers and Adjusters regarding patient care with WC cases.
  • Verify Insurance Eligibility and Benefit information for Private Pay new patients.
  • Assist Human Resources with new onboarding CNA and HHA workers and yearly updates for existing workers.
  • Assist with On-Call after hours and weekends as needed.

Client Relations Specialist

First Choice Background Research
11.2013 - 05.2015
  • Implemented customer service processes for clients and applicants walking them through background screening questions and system.
  • Set up new client accounts with documentation, username, passwords for system as needed
  • Responded to client and applicant calls and emails to answer questions about background check status.
  • Obtained background check data on characters, financial statuses and personal histories.
  • Conducted comprehensive interviews with subjects, employers, associates, references and other individuals.
  • Created quarterly TAT spreadsheets to track client screening submissions.

Store Manager

Book Express, Inc
08.2011 - 10.2013
  • Managed inventory control, cash control, and store opening and closing procedures.
  • Maintained proper product levels and inventory controls for merchandise and organized backroom to facilitate effective ordering and stock rotation.
  • Place inventory orders and prepare invoices for textbook and merchandise orders.
  • Reconciled daily sales transactions to balance and log day-to-day revenue.
  • Train other employees
  • Trained new employees on proper protocols and customer service standards.
  • Log and track employee working hours.
  • Assist with outside Marketing as needed.

Education

Associate of Arts - Business Fundamentals

University of Phoenix
Tempe, AZ
10.2022

High School Diploma -

McArthur High School
Pembroke Pines, FL
05.2010

Skills

  • Proficient in Microsoft Office
  • Fluent in two languages
  • Customer service expertise
  • Health insurance verification expertise
  • Workers' compensation management
  • Healthcare scheduling
  • ICD-10 classification knowledge
  • Accurate data entry
  • Clinical data organization
  • Quality assurance in documentation
  • Effective communication
  • Demonstrated skill impact
  • Experienced in subject matter expertise
  • Strategic decision making
  • Workforce planning
  • Claims denial management
  • Team collaboration skills
  • Internal audit experience

Timeline

Third Key Manager

Fossil Outlet Store
09.2024 - Current

Revenue Integrity Specialist

HCA Healthcare, Inc. - Parallon
09.2023 - Current

Insurance Verification Coordinator

HCA Healthcare, Inc. - Parallon
06.2022 - 09.2023

Prior Authorization Coordinator

HCA Healthcare, Inc. - Parallon
03.2020 - 06.2022

Customer Service Representative

HireRight
04.2019 - 02.2020

Intake & Staffing Coordinator

Caring Home Care
02.2018 - 04.2019

Intake & Staffing Coordinator

Maxicare Select, Inc
07.2015 - 01.2018

Client Relations Specialist

First Choice Background Research
11.2013 - 05.2015

Store Manager

Book Express, Inc
08.2011 - 10.2013

Associate of Arts - Business Fundamentals

University of Phoenix

High School Diploma -

McArthur High School

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Viviana Saez