CLARA RIVERA
South Gate
Summary
Healthcare professional with extensive experience in prior authorization coordination, committed to improving patient access to necessary treatments. Known for effective collaboration and delivering results in dynamic healthcare environments. Possesses strong analytical skills and attention to detail, ensuring smooth operations and high-quality service.
Overview
16
16
years of professional experience
Work History
Prior Authorization Coordinator
Acuity Eye Group
10.2018 - 02.2025
- In charge of requesting and obtaining approved auth’s for 5 different Ambulatory Surgery Centers.
- Call insurances for any missing information or code on approvals.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Authorized surgical requests in accordance with applicable plan guidelines.
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
- Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
Cook
Del Taco
04.2017 - 09.2018
- Maintained a clean and sanitary workspace, ensuring compliance with health and safety regulations.
- Prepared meals efficiently under time constraints for timely service during peak hours.
- Reduced food waste significantly by implementing proper portion control and storage techniques.
- Created identical dishes numerous times daily with consistent care, attention to detail, and quality.
- Maintained well-stocked stations with supplies and spices for maximum productivity.
Receptionist Administrator
AM Holly Charter
01.2009 - 01.2010
- Answered incoming calls, directing clients to individuals addressing specific needs.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Kept reception area clean and neat to give visitors positive first impression.
- Handled complaints and questions, and re-directed calls to other team members.
Education
High School Diploma -
Compton High School
Compton, CA06.2010
Skills
- Bi-lingual
- Attentive
- Reliable
- Hard-working
- Multi-tasker
- Teamwork
- Communication
- Remote Work Tools
- HIPAA compliance
- Strong organization
- Authorizations
- Retro-authorizations
- Data entry proficiency
- Critical thinking
- Outpatient surgery coding
Languages
Spanish
Full Professional
Timeline
Prior Authorization Coordinator
Acuity Eye Group
10.2018 - 02.2025
Cook
Del Taco
04.2017 - 09.2018
Receptionist Administrator
AM Holly Charter
01.2009 - 01.2010
High School Diploma -
Compton High School
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