Yasmine Lastra
Lehigh Acres,FL
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
8
8
years of professional experience
Work History
Utilization Intake Coordinator
Vālenz
04.2022 - Current
- Ability to Provide Certification/Authorizations based upon scripted clinical algorithms or benchmark Length of Stay
- Ability to read and interpret Summary Plan Documents and other resources relating to service requests
- Responsible for documenting completely and appropriately demographic information obtained from telephone,fax, or emailed requests within EMR system
- Makes outbound calls to follow-up on discharge information or request updated clinical information as necessary for concurrent review
- Screening inquiries to determine the services that require certification at the time of the inquiry
- Obtain clinical information and forwards the caller to the clinical staff for completion of the review
- Completed intake assessment forms and filed clients' charts.
- Answered phone calls and provided new clients with required paperwork to initiate service.
- Enhanced office productivity by handling high volume of callers per day.
Payment Coordinator
American Oncology Network
10.2021 - 04.2022
- Post Insurance/Patient Payments by Check, Credit card, EFT
- Ensures allowances and adjustments and write offs are posted accurately for all insurances such as Medicare/Medicaid/Commercial
- Post zeros pays, Overpayments, Forwarding balances, and Interest charges
- Maintains a thorough understating of all aspects of payment posting and EOB key data
- Ability to Research and obtain Remits and EOBS from various Insurance companies
- Posts payments by line item into Billing system to patients accounts within the assigned turn around time
- Balances daily posting batches and reconcile daily lockboxes, Eras and EFT payments
- Sort checks and mail them to appropriate Lockboxes.
Insurance Verification Coordinator
American Oncology Network
09.2019 - 10.2021
- Register/Verify Patients insurance benefits for 50+ Patient accounts
- Verify Eligibility for Commercial/Medicaid/Medicare/Group/Tricare/VA/Limited plans
- Obtain benefits such as Office visits/Diagnostic Labs/DME/ MRI/CT/PET Chemotherapy and Injections
- Ability to determine patient responsibility and Document account for deductible/Coinsurance and copays that need to be collected
- Ability to determine In-network/Out of network benefits for providers such as verifying contracts
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Assisted with medical coding and billing tasks.
Member Advocate
Suncoast Credit Union
03.2019 - 09.2019
- Assisted customers with banking needs and inquiries.
- Explain requirements and fees associated with different accounts (Business,Personal,Trust, Fiduciary)
- Educate Members on online services and mobile apps
- Opened new accounts and made changes to existing accounts.
- Investigated and resolved account issues by offering applicable options to customers.
- Handled various accounting transactions.
- Educated customers on online banking and mobile banking applications.
- Monitored and verified suspicious activity on customer accounts.
- Received mortgage, loan or public utility bill payments, verifying payment dates and amounts due.
- Cross-sold wide range of services and products to increase new business and expand existing customer relationships.
Member Service Representative
Blue Cross Blue Shield
05.2015 - 03.2019
- Provide Eligibility/Benefits/Claims/Authorizations for Member and Providers
- Take payments & Resolve billing issues and Reinstate Policies
- Give authorization status, dates and explanations as to why authorization is getting denied
- Research Claim Denials and send request to Adjust claims
- Call Provider Offices to relay claim denials and provide information needing/missing to process
- Assign PCPs and set up appointments
- Set up COB
- Became the "go-to" person for new reps and particularly challenging calls
- Maintained a high customer service ratings -earned 100% marks in all categories including communication skills, listening skills, problem resolution and politeness and FCR.
Education
High school diploma -
East Lee County High School
Lehigh Acres, FL05.2015
Skills
- Quick learner
- Adapts to new Workflows
- Medical Billing
- ICD Coding
- CPT Coding
- Medical office experience
- Critical Thinking Skills
- Medical Records Review
- HIPAA
- Utilization review
- Registration data intake
Timeline
Utilization Intake Coordinator
Vālenz
04.2022 - Current
Payment Coordinator
American Oncology Network
10.2021 - 04.2022
Insurance Verification Coordinator
American Oncology Network
09.2019 - 10.2021
Member Advocate
Suncoast Credit Union
03.2019 - 09.2019
Member Service Representative
Blue Cross Blue Shield
05.2015 - 03.2019
High school diploma -
East Lee County High School
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