Zitlali Jimenez
Henderson,NV
Summary
Knowledgeable Pre Authorization Specialist with proven track record in managing authorization processes and ensuring compliance with industry standards. Demonstrated expertise in problem-solving and attention to detail in the non clinical industry for Medical billing, Collections, and Pre Authorizations.
Overview
7
7
years of professional experience
Work History
Pre Authorization Specialist II
Centene Corporation- Health Net
02.2022 - Current
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Answering phone queques for post stabilization requests
- Verify Eligibility and Benefits
- 70+ faxes daily
Customer Service Representative
Lending USA
05.2021 - 01.2022
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Inbound outbound calls 100+ daily
- Account follow ups/ notations 50+ daily
Medical Collections Representative
Key Health
01.2019 - 02.2021
- Mailing statements/ processing faxes
- Managed a high volume of accounts, prioritizing those requiring immediate attention while consistently meeting performance targets.
- Reduced delinquency rates by maintaining consistent communication with attorneys and discussing outstanding lien balance.
- Inbound/ outbound calls 100+ daily
- Data entry
- Team work (Quotas)
Medical Billing Specialist
NBS Medical Management
01.2018 - 01.2019
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Statement mailing
Education
AA - General Studies
Pierce College
Woodland Hills, CAMedical Billing
Northwest College
Van Nuys, CA06.2019
High School Diploma - General Studies
John F Kennnedy High School
Granada Hills, CA06.2017
Languages
Spanish
Native or Bilingual
Timeline
Pre Authorization Specialist II
Centene Corporation- Health Net
02.2022 - Current
Customer Service Representative
Lending USA
05.2021 - 01.2022
Medical Collections Representative
Key Health
01.2019 - 02.2021
Medical Billing Specialist
NBS Medical Management
01.2018 - 01.2019
AA - General Studies
Pierce College
Medical Billing
Northwest College
High School Diploma - General Studies
John F Kennnedy High School
Similar Profiles
Alma MartinezAlma Martinez
Contact Center Supervisor at Centene Corporation/ Health NetContact Center Supervisor at Centene Corporation/ Health Net
NICOLE LUMIVESNICOLE LUMIVES
Appeals and Grievance Coordinator I at Centene Corporation: Health NetAppeals and Grievance Coordinator I at Centene Corporation: Health Net
Tisha WilsonTisha Wilson
TRICARE Education Specialist at Health Net Federal Services/Centene CorporationTRICARE Education Specialist at Health Net Federal Services/Centene Corporation
Hazel TorresHazel Torres
Mortgage Loan Officer at UNIFY Financial Credit UnionMortgage Loan Officer at UNIFY Financial Credit Union
Daisy LeeDaisy Lee
Bartender - Diplomat Prime Steaks at Hilton Diplomat Beach ResortBartender - Diplomat Prime Steaks at Hilton Diplomat Beach Resort