Nayeli Hernandez
Knightdale
Summary
Detail-oriented and highly organized administrative professional with comprehensive knowledge of medical standards, compliance regulations, and healthcare operational procedures. Experienced in patient scheduling, surgical coordination, prescription processing, and inventory management. Strong understanding of medical compliance standards and operational workflows, ensuring accuracy and regulatory adherence. Bilingual and highly efficient, with a proven ability to enhance patient satisfaction
Overview
15
15
years of professional experience
1
1
Certification
Work History
Front desk/ Surgical Coordinator
Carolina Pediatric Dentistry
Raleigh
05.2022 - Current
- Coordinated patient schedules for surgical appointments and consultations.
- Managed communication between families and dental professionals regarding treatment plans.
- Maintained accurate patient records and updated surgical documentation promptly.
- Check patients in and out; calculate and collect balance's
- Coordinate dental surgeries with WakeMed, local surgery centers, and anesthesia team.
- Send required documentation to appropriate facilities
- Request and manage clinical notes from providers
- Answer multi-line phone system and schedule patient appointments
Prior Authorization Technician 1
AmeriHealth Caritas Family Of Companies
Raleigh
07.2021 - 05.2022
- Responsible for understanding and applying clinical criteria for processing Prior Authorization requests in a timely manner for pharmacy and medical billing.
- Responsible for making outbound calls/receiving inbound calls, speaking with physicians’ offices for additional information or clarifications needed to process prior authorization request.
- Strong knowledge in Specialty pharmaceuticals
- Ability to identify problems including complex issues and determine solutions, both independently or in a team/group setting
- Maintains a balance of productivity, quality and timeliness of job accountabilities. Participates in department self-audit procedures for on-going evaluation of service.
- Maintains and updates internal databases. Enters application information, prior authorizations and other relevant data. Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis.
- Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with internal and external business partners at all times.
- Performs other related duties as assigned.
- Attends required training on an annual basis.
- Must be available to work weekends and holidays.
Pharmacy Technician
CVS Pharmacy
Raleigh
06.2016 - 07.2021
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
- Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
- Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.
- Assisted patients in minimizing medical expenses by recommending generic alternative prescription medications.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Counted and labeled prescriptions with correct item and quantity.
- Restocked automated medication dispensing equipment.
- Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
- Counted, measured and compounded medications following standard procedures.
- Entered and processed patients' prescriptions into internal system.
- Counted, measured, and compounded medications following standard procedures.
Orthodontic Assistant
Dr. King Orthodontist
Raleigh
01.2013 - 11.2014
- Prepped all examination rooms, sterilized equipment and instruments and maintained appropriate tray setup.
- Educated patients on postoperative care and best practices for protecting dental work and boosting healing process.
- Taught patients strategies for boosting oral hygiene, controlling plaque and protecting tooth enamel from long-term damage.
- Poured and shaped molds from impressions and trimmed molds in grinder.
- Prepared patient for orthodontist and performed simple tasks such as tightening braces and conducting preliminary examinations.
- Helped Orthodontist complete routine and advanced procedures by preparing patients and instruments for expected needs.
- Assisted dentists by passing instruments, suctioning intraoral fluids, adding water and mixing materials for fillings, and impressions.
- Cleaned and sanitized dental tools and equipment, straightened treatment rooms and restocked supplies to prep for next patient and maintain health and safety practices.
- Assisted dentists, hygienists and other personnel by handing appropriate tools and supplies needed for procedures.
Receptionist
Nail Spa - Nail Salon
Raleigh
04.2011 - 01.2012
- Confirmed appointments, communicated with clients and updated client records.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Oversaw inventory activities, including materials monitoring, ordering or requisition and supply stocking or re-stocking.
- Kept reception area clean and neat to give visitors positive first impression.
- Escorted clients to correct spa areas including treatment rooms and offices.
- Learned details of types of treatments and procedures in order to answer questions from spa guests.
- Communicated with spa team members if clients canceled or changed appointment times.
- Trained new hires on new appointment scheduling, opening, closing duties and generating and balancing daily revenue reports.
- Kept calendar with scheduled appointments and scheduled massage therapists for appropriate treatments and time slots.
Education
Certificate - Pharmacy Technician
El Camino College
Torrance, CAHigh School Diploma -
Knightdale High School
Knightdale, NCSkills
- Detail-Oriented & Fast Learner
- Bilingual (English/Spanish)
- Surgical & Treatment Coordination
- X-ray certified
- CPR certified
- Ability to multi-task and prioritize work
- Ability to comprehend and follow established office routines, policies and procedures
- Customer service and interpersonal skills
- Ability to adjust based on business/department needs
- Demonstrated courteous and professional behavior
- Proficient PC skills in a windows based environment
- Excellent oral and written communication skills
- Customer service
- Task prioritization
- Scheduling expertise
- Data entry efficiency
Certification
- Certified Pharmacy Technician
Languages
Spanish
Timeline
Front desk/ Surgical Coordinator
Carolina Pediatric Dentistry
05.2022 - Current
Prior Authorization Technician 1
AmeriHealth Caritas Family Of Companies
07.2021 - 05.2022
Pharmacy Technician
CVS Pharmacy
06.2016 - 07.2021
Orthodontic Assistant
Dr. King Orthodontist
01.2013 - 11.2014
Receptionist
Nail Spa - Nail Salon
04.2011 - 01.2012
Certificate - Pharmacy Technician
El Camino College
High School Diploma -
Knightdale High School