Elias Rodriguez
Glendale,AZ
Summary
Detail-oriented healthcare professional with 6+ years of experience in claims analysis, insurance verification, and payer resolution. Skilled in managing prior authorizations, interpreting payer requirements, and reducing denials through accurate documentation and follow-up. Strong knowledge of ICD-10-CM, CPT, HCPCS coding, and insurance benefits across Medicare, Medicaid, and commercial plans. Adept at working independently in high-volume environments while maintaining accuracy, compliance, and patient-focused communication.
Overview
2026
2026
years of professional experience
Work History
Claims Analyst
Centene Corporation
01.2018 - 12.2023
- Verified insurance coverage, benefits, and prior authorization requirements across Medicare, Medicaid, and Marketplace plans.
- Reviewed CPT/ICD coding and authorizations to ensure proper claim processing and reimbursement.
- Resolved escalated claims by collaborating with providers, payers, and internal teams to reduce denials.
- Documented claim activities thoroughly to support accurate billing and minimize penalties from payers.
- Served as a resource to peers for payer policy interpretation and claim adjudication.
- Maintained 100% audit compliance while consistently exceeding productivity metrics.
Medical Billing & Coding Training
U.S. Career Institute (Remote)
2024 - 2025
- Completed coursework in medical terminology, CPT, ICD-10-CM, and HCPCS coding.
- Practiced hands-on coding, claims submission, and payer-specific regulations.
- Strengthened skills in EHR systems, insurance reimbursement processes, and denial prevention.
Painter/Finisher
The Wood Master
03.2020 - Current
- Mix and apply custom stains, topcoats, and finishes, requiring strong attention to detail and adherence to client specifications.
- Prepare and inspect surfaces to meet quality and compliance standards.
- Communicate with clients to set expectations, update progress, and ensure satisfaction—developing strong customer service and interpersonal skills.
- Track and maintain inventory, ensuring supplies are available and OSHA/EPA safety standards are met.
- Manage daily workflows independently while meeting project deadlines.
Administrative Data Entry Clerk
Barr Credit Services
06.2017 - 12.2017
- Completed insurance and financial data entry tasks with accuracy and efficiency.
- Followed established procedures to enter and process data correctly.
- Organized, sorted, and checked input data against original documents.
- Scanned documents and saved in database to keep records of essential organizational information.
Central Receiving Clerk
Walmart Distribution Center
04.2017 - 06.2017
- Maintained tidy, organized and safe work area to comply with cleanliness standards.
- Regularly reviewed invoices and double-checked orders.
- Unloaded pallets and deliveries and organized products in warehouse.
- Reduced errors and discrepancies by meticulously verifying shipment contents against purchase orders and invoices.
Education
Certified Professional Coder- Apprentice (CPC-A)
AAPC- Pending
09-2025
Medical Coding And Billing Certificate
U.S. Career Institute
Fort Collins, CO03-2025
Associate of Business
Central Arizona College
Coolidge, AZ05-2016
High School Diploma -
Casa Grande Union High School
Casa Grande, AZ05-2011
Skills
- Insurance Verification & Pre-Authorizations
- Denial Prevention & Resolution
- ICD-10-CM, CPT, HCPCS Knowledge
- Payer Policy Interpretation & Contract Review
- Referral & Scheduling Coordination
- EOB Review & Documentation Accuracy
- Microsoft Office, EHRs & Multiple System Navigation
- Patient & Provider Communication
- HIPAA Compliance & Confidentiality
- Remote Work Productivity & Time Management
Languages
Spanish
Native or Bilingual
Timeline
Painter/Finisher
The Wood Master
03.2020 - Current
Claims Analyst
Centene Corporation
01.2018 - 12.2023
Administrative Data Entry Clerk
Barr Credit Services
06.2017 - 12.2017
Central Receiving Clerk
Walmart Distribution Center
04.2017 - 06.2017
Medical Billing & Coding Training
U.S. Career Institute (Remote)
2024 - 2025
Certified Professional Coder- Apprentice (CPC-A)
AAPC- Pending
Medical Coding And Billing Certificate
U.S. Career Institute
Associate of Business
Central Arizona College
High School Diploma -
Casa Grande Union High School
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