Surgical Coordination and Administrative Specialist
Resume:
Madeline Horenstein
Pembroke Pines, FL 33025
Email: *********@*****.***
Phone: 305-***-****
Surgical Coordinator
Center for Gynecologic Oncology - Miramar, FL
March 2023-Present
• Interview and schedule patients for surgery
• Verify insurances and obtain authorization for patients
• Schedule diagnostics test and imaging
•Schedule patients Pre-operative clearance and Post-operative appointment
• Verifies third party payer information via the web or telephone
• Coordinate the procurement of surgical supplies and equipment
• Monitor surgical schedules and make adjustments as needed Referral Coordinator Remote WFH
Caremax Medical Center - Miami Lakes, FL
January 2021 to January 2023
• Process and authorize referrals
• Verifies third party payer information via the web or telephone.
• Requests and documents appropriate authorization for hospital and physician services via web or fax and follows up until authorization is obtained.
• Process Medical Records request
• Communicates with appropriate departments if any issues/questions arise and/or to accommodate any special needs for patients.
• Schedule & set-up transportation
• Coordinate referral appointment, maintain and update patient records
• Verify patient insurance information, and provide administrative support Claims Benefits Specialist- Remote WFH
Aetna, a CVS Health Company - Miami Gardens, FL
June 2021 to June 2022
• Process International claims,
• Review pre-specified claims or claims that exceed specialist adjudication authority or processing expertise.
• Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process.
Front Desk Coordinator/Receptionist
Illumina Medical Centers - Aventura, FL
June 2019 to April 2021
• Greets patients and families in person or on the telephone in a respectful and empathetic manner. Responds to questions and/or problems and keeps open lines of communication with patients/families.
• Verifies third party payer information via the web or telephone.
• Requests and documents appropriate authorization for hospital and physician services via web or fax and follows up until authorization is obtained.
• Process Medical Records request
• Communicates with appropriate departments if any issues/questions arise and/or to accommodate any special needs for patients.
• Schedule & set-up transportation
• Coordinate referral appointment, maintain and update patient records
• Verify patient insurance information, and provide administrative support Patient Access/ Medical Support- Ophthalmology
Nicklaus Children's Health System - Miami, FL
February 2015 to April 2019
• Greets patients and families in person or on the telephone in a respectful and empathetic manner. Responds to questions and/or problems and keeps open lines of communication with patients/families. • Interviews patients/families to obtain demographic, third party payer, financial/medical information, and identification to schedule, pre-admit/admit, or pre- register/register patients.
• Verifies third party payer information via the web or telephone.
• Requests and documents appropriate authorization for hospital and physician services via web or fax and follows up until authorization is obtained.
• Documents all activities in the Collection Notes file of the computer system as appropriate.
• Obtains all necessary consents for patient.
• Directs families to appropriate location in the facility.
• Verifies patients are accompanied by legal guardian and notifies Risk Management if patient is present with anyone other than legal guardian for any non-emergent visits.
• Notifies and educates patient/family of financial responsibility and documents collections in hospital system.
• Communicates with appropriate departments if any issues/questions arise and/or to accommodate any special needs for patients.
• Obtains and validates prescriptions when appropriate.
• Places and monitors patients arriving to ACC for services by using patient tracking system.
• Corrects any registration errors made utilizing the QA system.
• Scans all documents to the appropriate folder in the PEDS system.
• Schedules hospital and/or physician services as appropriate.
• Triages incoming facility inquiries and routes appropriately. Voucher Processor I
Quadel Program Services - Miami, FL
May 2012 to June 2014
• Works cooperatively with others members of the Voucher team, adjusting workload as needed when others are ill or on vacation
• Communicate with applicants, participants, landlords/owners and co-workers in a that is courteous and professional
• Place information received through the mail, by fax, or email in appropriate part of file
• Ability to communicate interpersonally
• Process Interim when participant reports changes in income or family circumstances, process adjustment
• Make determination in accordance with the Admin Plan when tenants request to add family members for reasons other than the birth, adoption or Court-awarded custody of children
• Process Annual re-certification in a manner that ensure that notices of rent increase are provided at least 30 days before the anniversary date
• Determine whether the participant family qualifies for different unit/Voucher size when appropriate
• As the utility allowance schedule is updated, ensure that the utility allowance used in determining tenant rent are correct and accurate,
• Enter correct information and forward accurate and timely 50058 form
• Conduct criminal background check on all adult members of applicant families
• Obtain EIV or third party verification of income
• Calculate Adjusted Income correctly in accordance with HUD
• Calculate Total Tenant Payment accurately
• Perform other duties as assigned
Education
High School Diploma
Corporate Academy North - Miami, FL
1996 to 1999
Skills
Problem-solving • Team Work
Reliability
Flexibility
Medical Records
Ophthalmology Experience • Front desk
Triage
Medical Scheduling
Customer service
Remote – WFH experience
Languages
English
Spanish - Fluent
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