Debbie Luna
@debbieluna
Goal-oriented administrative professional with healthcare management expertise.
What I'm looking for
I am a dedicated administrative professional with over ten years of experience in healthcare administration. My career has been marked by a commitment to excellence and a passion for supporting executives in achieving their goals. I thrive in fast-paced environments, where my multitasking and problem-solving skills come into play. I am proficient in managing teams and ensuring that all operations align with company policies and procedures.
In my current role as a Manager at Provider Network Solutions, I oversee a team of Provider Service Coordinators and Credentialing Coordinators. My responsibilities include empowering employees, delegating tasks, and conducting quarterly training to keep the team updated on industry standards. I take pride in my ability to audit processes and ensure that deadlines are met, contributing to the overall efficiency of the department.
Throughout my career, I have developed strong organizational and communication skills, which have enabled me to coordinate effectively with various stakeholders. I am now seeking to leverage my expertise in a growing company where I can continue to make a positive impact.
Experience
Work history, roles, and key accomplishments
Manager
Provider Network Solutions
May 2018 - Present (7 years 2 months)
Provided support, oversight, and management to Provider Service Coordinators and Credentialing Coordinators, ensuring adherence to policies and procedures. Evaluated and implemented department training quarterly to keep the Provider Relations team updated on Network, TPA, and healthcare business standards.
Precertification Rep / DME Rep / Denial Backup
Care Plus Health Plan
Jul 2011 - Present (14 years)
Received and entered all DME referral requests into the CSC computer system, assisting precertification Medical Directors in communicating denials/approvals. Generated denial letters and worked closely with the Medical Director, Compliance team, and Nursing Staff to ensure timely completion of denials.
Education
Degrees, certifications, and relevant coursework
Hialeah High School
High School Diploma, General Studies
Completed high school education with a focus on general studies. Developed foundational skills in various subjects.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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