Yesenia Vazquez
Yonkers,NY
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 3 years of managing documentation. Considered team player with exemplary multitasking skills. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Clinical Pharmacy Liaison
East Harlem Council For Human Services
2019.11 - Current
- Coordinated with physicians and insurance agency representatives for speedy resolution of prescription discrepancies.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Scheduled appointments with specialists on behalf of clients.
- Performed various administrative tasks by filing, copying and faxing documents.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Pharmacy Clerk
Trust Pharmacy
Yonkers , NY
2014.08 - Current
- Proficient in Micro Merchant system used for filing and reconciliation of prescription
- Register new patients information into the Micro Merchant system
- Query physician’s offices on medication concerns and contraindications
- Communicate with insurance companies regarding prior authorizations for certain prescriptions
- Use medical coding to identify diabetic patients in need of specific instructions or follow up
- Knowledge of Medicaid and Medicare policies for prescriptions and prior authorizations
- Able to explain directions of any medications to our clients
- Handle cash, credit and check transactions
Health Information Management Clerk
Urban Health Plan
2018.11 - 2019.11
- Upheld HIPAA regulations and standards for protecting patient information.
- Retrieved medical data for physicians and patients.
- Secured confidential patient information from unauthorized access.
- Generated medical reports on patient admissions, treatment and discharge for disbursement to various departments.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to learn quickly and adapt to new situations.
- Worked well in a team setting, providing support and guidance.
- Worked effectively in fast-paced environments.
Education
BBA -
06.2020
AAPC Certified Professional Coding Course - undefined
03.2019
Skills
- Knowledge of Microsoft Office: Excel, Outlook, Powerpoint, and Word
- Pharmacy Management Software
- Prescription Interpretation
- Authorizations
- Patient Referral
- Medical Coding
- Typing Medication Labels
- Clinical Data Entry
- Patient Care and Monitoring
Certification
- 340B UNIVERITY ONDEMAND FOR HEALTH CENTERS Training - 06/0/2022
Languages
Spanish
Native or Bilingual
Timeline
Clinical Pharmacy Liaison - East Harlem Council For Human Services
2019.11 - Current
Health Information Management Clerk - Urban Health Plan
2018.11 - 2019.11
Pharmacy Clerk - Trust Pharmacy
2014.08 - Current
The College of Westchester Healthcare Administration - BBA,
- AAPC Certified Professional Coding Course,
- 340B UNIVERITY ONDEMAND FOR HEALTH CENTERS Training - 06/0/2022
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