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s miguelSM
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s miguel

@smiguel

I prevent credentialing and authorization disruptions across healthcare payer, provider, and pharmacy operations.

United States
Message

At Ro, I manage prior-authorization and pharmacy coordination for government-funded and commercial payer accounts, resolving licensure, enrollment, NPI, and credentialing issues before they disrupt billing or patient access.

I've supported compliance and health information operations at Valerion Health and Datavant, maintaining audit-ready provider records for hospital systems including Legacy Hospitals, UT Tyler, Christus Health, Wycoff, and Mt. Sinai. I process high-volume records and documentation requests for hospitals, insurance companies, and PBMs while ensuring each submission meets recipient requirements.

I build consistent quality checks that improve data accuracy, reduce rework, and keep critical provider information current across internal systems.

Experience

Work history, roles, and key accomplishments

Ro logoRO
Current

Prior Authorization & Pharmacy Coordinator

Managed administrative duties for government-funded and commercial payer accounts, including updating demographics, tracking licensure, and resolving credentialing issues. Processed credentialing and re-credentialing issues daily, verified DEA numbers and state licenses, and served as a liaison between clinical and administrative teams.

Education

Degrees, certifications, and relevant coursework

s hasn't added their education

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Tech stack

Software and tools used professionally

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