Leslie Ruiz-Calix

**** ****** **, **** ****** 626-***-**** ad49fd@r.postjobfree.com

Profile

Dedicated Medical Assistant; with eight years of experience in health care and utilization management and authorization. I am skillful in conducting comprehensive reviews, and patient care while minimizing costs. I am seeking to contribute my experience, to a dynamic healthcare organization to ensure efficient resource assignment and superior patient outcomes.

Experience

MEDICAL ASSISTANT UM COORDINATOR DR. KUNDI SEPTEMBER 2007

·Hands on experience in medical record. Prevent drug interaction and contributed to diagnosis by recording patient health information. Monitoring vitals and updating patient files.

·Checked eligibility for medical billing with correct CPT and ICD coding.

·Arranged patient to medical procedures with authorized prior authorization with contracted IPA, PPO or Medical Medicare regulations.

·Creating new patient charts and follow.

UTILIZATION AUTHORIZATION REVIEW SPECIALIST DR. ANANT RAMAPRIL JUNE 2023

. Making sure patient had Prior Authorization for new, follow up, retro, consultations. Tracking and collection of medical reports for Authorization request needed procedure such as follow up surgeries treatment for excellent patient experience.

. Checking eligibility for new patient visits, follow up and patient treatment. Collecting prior authorization; with correct CPT and ICD with Authorization approval.

. Request for medical records; following HIPPA guidelines for patient authorization prior for surgery, and treatment. Collaborated with hospitals surgery department to schedule surgery and admitting.

. Coordinate patient with pre-op with diagnostic test, laboratory, X-ray, MRI medical clearance and post-op care with proper documentation for after care instructions, and accommodations with home health, DME, and physical therapy if needed.

. Communicate with claims medical billing of insurances, payments and denials. Sending letters to patients for medical needs and pending payments.

Education

MEDICAL ASSISTANT CERTIFICATE AUGUST 2005 NORTH WEST COLLEG

AUGUST 2005 MOUNTAIN VIEW HIGH SCHHOL DIPLOMA

Skills & Abilities

·Hands on experience in Utilization review and management. HIPPA, MEDI-MEDI

proficient in assessing medical records, treatment

·Exceptional communication and interpersonal skills for collaboration with healthcare team.

·Knowledge in ICD CPT-10 coding, medical billing