Hanna Rodriguez

Senior Medical Coordinator

McKinney, TX 75069

ad26cj@r.postjobfree.com

+1-214-***-****

Highly qualified Benefits Verification Specialist / Medical Claims and Medical Coordination with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and would excel in the collaborative environment on which your company prides itself. Authorized to work in the US for any employer

Work Experience

Field Solutions Case Manager / Cite Team

Cardinal Health - Remote

July 2023 to Present

• Field Solutions, is responsible for providing specialties support and expertise in the areas of advice and consulting, research, and patient care to internal business units and external customers

• Provided patient support to patients who have opted into PAC support

• Assistance with welcome calls, relaying BI results, updating the patient on PA/Appeal status, follow up on missing information, etc.

• CITe team will place outbound calls to HCPs to address: Specific patient needs,Missing Information,Portal troubleshooting, Other HCP escalations

• Case audits to ensure in guidelines with Pfizer

• First level escalations

• Assisting with CM work when needed

• Work in Progress Reports : including Securing Message report, BI report,Triage report,PA/Appeal report o PPAP audit report o PAC report, Program Product report, Follow up reports (SP F/U, MI F/U, PA F/U, PAP F/U, Docs Received)

• Manage and maintain a daily spreadsheet that clearly tracks all encountered issues and steps taken to resolve issues.

Senior Coordinator

Alacura Medical Transport - Dallas, TX

August 2021 to January 2023

Role and Responsibilities

• Intake from in-bound calls as well as digital transport request also bilingual patients .

• Obtain a comprehensive understanding of the patient's medical condition

• Provided professional, accurate, timely insurance verification and notification for outpatient diagnostic services, observation and inpatient services.

• Coordinates with the aviation and ground dispatch personnel to identify the most appropriate servicing provider and crew to support the patient's transport needs.

• Obtains insurance precertification & authorizations for transportation

• Verified insurance benefits for commercial, Medicare, and Medicaid Payers (Phone and Website)

• Claims and Billing

• Efficient medical documentation auditing for code appropriateness and guidelines

• Coded provided services using ICD9 CPT4 HCPCS and DRG billing formularies

• Submitted bills for reimbursement to private i

• Provider Networking- contracting ground and air providers across the U.S .

• Closing end of month financial on all cases.

Senior Referral Coordinator

StratiFi Health - Plano, TX

August 2019 to July 2021

Role and Responsibilities

• Maintain ongoing tracking and appropriate documentation on referrals to promote teams awareness and ensured patient safety.

• Assembled information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist.

• Verify documents and coordinate health care coverage for patients, including eligibility of benefits.

• Detail knowledge of medical coding; ICD-9, CPT and HCPCS codes.

• Assist with special reports of tracking problem medical claims according to HIPPA guidelines.

• Review and resolve claim appeals according to policy guidelines.

• Established and maintain relationships with identified service providers.

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• Resourcefulness in problem solving

• Strong follow through with delegated tasks and accountability

• Proficient Computer skills

• Process oriented

• Able to produce high quality outcomes

• Trained all new hires on a variety of daily task. Referral Coordinator

LIBERTY HEALTH CARE CENTER - Garland, TX

May 2017 to July 2019

Referral Coordinator-Liberty Healthcare, Garland/ Plano Tx

• Referral Coordinator for both Garland and Plano offices Check in/out including taking patient payments

• Preparation and completion of Radiology reports for Diagnostic Imaging Service.

• Collected and reviewed all patient insurance benefit information, to the degree authorized by the SOP of the program.

• Provided assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.

• Completed and submited all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors.

• Researched and resolved any electronic claim denials.

• Researched and resolves any claim denials or underpayment of claims.

• Effectively utilized various means for collections, including but not limited to phone, fax, mail, and online methods.

• Provided exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. Administrative Assistant

Dillard Associates - Garland, TX

May 2014 to May 2017

• Front desk duties

• Monthly Commission sales Reports for company

• Quickbook

•Invoicing all daily sales

• Delinquent Accounts working with customer to bring to good terms

• Open Sales Reports

• Working with Sales team on Marketing

• Inventory inhouse and warehouse

Education

Quickbooks in Quickbooks Accounting

Richland College

February 2007 to May 2007

Skills

• Data Entry

• Administrative Support

• Outlook

• Medical office experience

• Customer service

• Documentation review

• Medicare

• Managed care

• Outlook

• Microsoft Office programs (Word

• Excel

• Medical terminology

• Communication skills

• Computer skills

• Microsoft Office

• Medical Scheduling

• Insurance Verification

• Medical Records

• CPT Coding

• ICD-10

• Medical billing

• Office experience

• Workers' compensation

• Medical coding

• HIPAA

Languages

• Spanish - Fluent

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