Medical Assistant Prior Authorization

SACHIEL LOUIS JEAN

********@*****.***

Relevant Skill Set:

•Healthcare professional with 10+ years of experience in various healthcare settings

•Ability to handle 50+inbound and outbound calls to patients and insurance companies

•Experienced with verifying insurance, eligibility, bene, and prior authorization

•Knowledgeable in Medicare, Medicaid and other commercial health plan guidelines

•Utilized Microsoft Office Suite (Word, Outlook, and Excel) Emdeon, Availity, Meditech, and other client-based software

Professional Experience:

Advent health-Ocala, FL

September 2018 to Present

Referral Specialist:

•Responds to inbound calls from patients and insurance companies

•Performed outbound call to providers to gather required information

•Initiate processing of authorization requests for outpatient and inpatient services, and routing to the appropriate staff

One Homecare Solutions- Miramar, FL

December 2014 to August 2018

Intake Coordinator:

•Created flies for all new patients and taking all pertinent information

•Interacted with Medicare, Medicaid and Commercial products with providers and member benefits

•Held responsibility for making sure that each patient checked in for their appointment and had the proper insurance information on hand

•Reviewed patient demographics, verify eligibility, benefits and Prior Authorization

•Comprehended insurance coverage and Medicare/Medicaid Guidelines

•Provided telephonic support to patient inquiries/services calls

•Maintained and updated the existing patient files whenever a patient would change jobs or when insurance companies would change coverage plans

•Cooperated with contracted providers to determine claims status in accordance to state requirements

•Checked insurance eligibility by using numerous databases such as Emdeon, Availity, and insurance websites

Doctor Medical Center- Miramar, FL

August 2010 to December 2014

Referral Coordinator:

•Created patient files for new patients

•Greeted patients, verified and updated insurance

•Recorded patients’ medical history, test results in medical records

•Measured patient vital signs, weight and height

•Reviewed patient demographics, verify eligibility, benefits and Prior Authorization

•Maintained & cleaned exam rooms and all medical equipment • Administered patient’s blood and urine samples for lab processing

Certification:

Registered Health Information Technician (RHIT)- May 2025

Medical Assistant, National Healthcareer Association- July 2023

Education:

Associate Degree in Health Information Management- Orlando, FL

Medical Assistant, Stepful- Miami, FL

Respirating Therapist

High School Diploma, American Academy- Miami, FL

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