Amanda Castanon Email & Phone Number

United States

Deliver quality customer service and correspondence by politely answering incoming telephone calls in a high-volume call center environment from healthcare professionals regarding requests for pre-certification, claims, and enrollment applications. Maintain efficient processes while verifying member eligibility by accessing multiple eligibility systems. Utilize multiple database systems in verifying the participation status of professional and facility providers. Strictly adhere to the departmental standards for staff time, after-call work, attendance, and non-queue productivity. Enforce stellar communication skills in explaining claim denials and payments and what can be done to rectify denials. Handle 50+ calls per shift and help providers accomplish their tasks by directing them to resources available on the Nevada Medicaid website and occasionally walking them through specific steps to get the required information. Increase customer satisfaction by answering all questions and concerns within 10 minutes or less. Thoroughly explain any corrections needed in an enrollment application, including medical licenses, business licenses, corporation breakdowns, board members’ information, etc. Leveraged industry best practices and gained vast knowledge of medical terminology, a general understanding of managed care delivery systems, and a familiarity with ICD-10 and CPT codes

Philadelphia, Pennsylvania, United States

As a Surgical Coordinator, I improved the delivery of patient care by optimizing administrative functions and effectively mitigating operational risks and inefficiencies. I promoted effective resource management by effectively coordinating schedules and preparing patients for Cataract, Retinal, Glaucoma, Pediatric procedures, and Blepharoplasty surgeries. I also coordinated and communicated closely with ambulatory surgical centers and hospitals to ensure service schedules were tracked and delivered in a high-volume, fast-paced clinic setting, which translated to improved patient service.In addition, I accounted for electronically prescribing eye drops and providing detailed instructions for use to patients prior to surgery. I independently organized and maintained the accuracy of health information and data in electronic systems by effectively utilizing a combination of technical skills and medical records knowledge. Besides that, I facilitated the collection of copays and deductibles from patients by correctly identifying the required transaction and effectively communicating the process to patients, thereby allowing smooth financial transactions and seamless patient service.

Staten Island, New York, United States

As a Medical Secretary, I conducted several secretarial tasks to streamline medical office functions, including appointment scheduling, phone call triaging, pre-certifications, phone correspondence, and patient data management. I guaranteed the completeness and accuracy of patient information in the administration of medical procedures and services. I also reviewed patient and billing information for data reconciliation and verification of demographics and insurance eligibility. Likewise, I acted as a biller for patients and third-party payers. Controlled receivables and kept track of office expenses to improve the budget.

Staten Island, New York, United States

In this role, I employed my expertise and enabled well-organized coordination of surgery schedules for eight orthopedic surgeons and four neurosurgeons by communicating directly with SIUH and numerous other hospitals and surgery centers. I promoted excellent service by maintaining optimal alignment of workflow operations per office procedures and policies. I also ensured clear procedure documentation by maintaining knowledge of complex clinical guidelines and medical management policies. On top of that, I communicated with physicians and physician assistants to clarify information about CPT codes, ICD-10 codes, and pre-testing results.

Staten Island, New York, United States

As an Authorizations Specialist, I played an integral role in obtaining medical procedure authorization approvals for nineoffice locations and six physicians within the practice by actively communicating with all types of commercial insurancecompanies. I promoted smooth practice operations by answering phone calls directed toward the authorizationdepartment. Also, I aided with easy transition and training processes for all departments by creating a user manual for AllScripts Pro Suite.

Staten Island, New York, United States

Under South Shore Physicians, I administrated all aspects of front-desk operations, including proactively interacting withpatients, effectively answering incoming calls, taking messages, and setting appointments while delivering outstandingcustomer service and ensuring information privacy.