RITA CANTU
Summerville
Summary
Efficient precertification specialist recognized for rapid and effective task management. Expertise includes insurance verification and patient records management. Strong communication, time management, and problem-solving skills ensure smooth preauthorization processes, enhancing patient care coordination and billing accuracy.
Overview
4
4
years of professional experience
Work History
Precertification Specialist
MUSC
Charleston
06.2023 - Current
- Facilitated precertification requests for medical services and procedures, ensuring timely approvals for patient care.
- Managed documentation and tracked precertification status in electronic systems, streamlining workflow and enhancing communication.
- Acted as liaison between staff, patients, and providers regarding authorization delays and appeals options.
- Collaborated with departments to resolve issues and gather additional information, supporting efficient authorization processes.
- Trained new employees on heart and vascular prior authorization processes.
Revenue Cycle Specialist
Evolution Consultants
New Braunfels
04.2022 - 06.2023
- Submitted claims to insurance companies, facilitating prompt payment.
- Reviewed claim denials and payer requirements to implement corrective actions.
- Managed patient billing processes to optimize timely revenue collection.
- Posted payments from insurance and patients accurately.
- Processed accounts receivable efficiently.
- Audited charts to confirm accurate charge capture of procedures.
- Researched and reconciled discrepancies on unpaid invoices effectively.
Skills
- Preauthorization workflows
- Patient authorization coordination
- Authorization management
- Authorization documentation review
- Data accuracy
- Time management and multitasking
- Task prioritization
- Team leadership
OBJECTIVE
My career goal is to grow into a supervisor role where I can use my strong work ethic, organization, accuracy, and leadership skills to support team success. I am committed to leading by example, helping others succeed and stay focused on goals, improving daily workflow and taking on added responsibilities that contribute to a positive and productive work environment.
Timeline
Precertification Specialist
MUSC
06.2023 - Current
Revenue Cycle Specialist
Evolution Consultants
04.2022 - 06.2023