Sandra Gutierrez
@sandragutierrez
Detail-oriented prior authorization specialist and medical biller with 6+ years in healthcare operations.
United StatesWhat I'm looking for
I am a detail-oriented Prior Authorization Specialist and Medical Biller with over six years of experience managing authorization workflows, verifying benefits, and resolving denied claims across multiple specialties. I am bilingual in English and Spanish, proficient with EHR/EMR systems (Epic, Athena, Healthpac), and committed to HIPAA-compliant, patient-focused service.
I have a track record of obtaining authorizations for outpatient surgeries and procedures, rebuilding denied claims through accurate CPT and ICD-10 coding, posting payments, and coordinating with insurers, providers, and patients to ensure timely approvals and smooth revenue cycle processes.
Experience
Work history, roles, and key accomplishments
Prior Authorization Specialist
R & B Solutions
Jan 2020 - Jul 2025 (5 years 6 months)
Initiated and coordinated prior authorization and billing processes remotely across specialties, including benefit verification, claim rebilling, appeals filing, and payment posting to recover revenue and assist patients with coverage questions.
Prior Authorization Specialist
Digestive Tract Consultants
Nov 2017 - Dec 2019 (2 years 1 month)
Requested and obtained prior authorizations for outpatient surgeries and biopsy procedures, coordinating with insurers, providers, and patients to secure approvals and ensure regulatory compliance. Tracked requests in EHRs, provided status updates, and resolved discrepancies while maintaining HIPAA confidentiality.
Education
Degrees, certifications, and relevant coursework
Sandra hasn't added their education
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Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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