Gloria Desmarets
Mesa
Summary
Dynamic Authorization Specialist with a proven track record at Tri-City Cardiology, excelling in prior authorization processing. Adept at enhancing patient satisfaction through effective communication and compliance with HIPAA regulations. Recognized for consistently demonstrating strong adaptability and attention to detail in fast-paced environments.
Experienced with managing complex authorization processes, ensuring compliance and efficiency. Utilizes strong problem-solving abilities to streamline workflows and enhance patient satisfaction. Knowledge of industry standards and team collaboration drives successful authorization management.
Overview
8
8
years of professional experience
Work History
Authorization Specialist
Tri-City Cardiology
12.2021 - 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.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
Front Office Coordinator
San Tan Cardiovasular Center
05.2020 - 08.2022
- Improved patient relations by proactively addressing concerns or complaints with professionalism and empathy.
- Handled financial transactions responsibly, collecting copayments and processing payments with attention to detail.
- Supported administrative tasks such as filing, data entry, and document management to maintain an organized office environment.
- Managed high call volumes effectively, addressing patient inquiries and resolving issues promptly.
- Managed inventory of office supplies, ensuring adequate stock levels were maintained for efficient daily operations.
- Enhanced patient experience by managing front office operations efficiently and professionally.
Patient Financial Services Representative
Banner Health CBO
05.2017 - 03.2020
- Maintained compliance with industry regulations, ensuring proper handling of sensitive patient data during the billing process.
- Improved patient satisfaction by providing timely and accurate financial information.
- Negotiated payment arrangements with self-pay patients, offering flexible solutions that aligned with their financial capabilities.
- Streamlined billing processes for increased efficiency and accuracy in payment collections.
- Reduced errors in billing, conducting thorough audits of patient accounts and identifying discrepancies.
- Coordinated closely with clinical teams to verify services rendered, ensuring accurate billing and reimbursement for all provided care.
- Assisted patients in understanding their financial responsibilities, guiding them through available payment options and resources.
Education
LVN - LVN
Summit Career College
Anaheim, CA09-2014
Medical Assisting
American Career College
CA09-2009
Skills
- Claims management
- Medical terminology expertise
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
- Knowledgeable in: NextGen, Cerner, EClinicals, EHR, MS Word, MS PowerPoint, MS Excel,
Timeline
Authorization Specialist
Tri-City Cardiology
12.2021 - Current
Front Office Coordinator
San Tan Cardiovasular Center
05.2020 - 08.2022
Patient Financial Services Representative
Banner Health CBO
05.2017 - 03.2020
LVN - LVN
Summit Career College
Medical Assisting
American Career College
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