Omar Corral
Chicago,IL
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 13 years of managing documentation. Considered team player with exemplary multitasking skills.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Fertility Centers of Illinois
12.2011 - 05.2025
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
Quality Assurance Inspector
RTC INC
08.2007 - 12.2011
- Performed visual inspections and non-destructive tests where appropriate.
- Reported repeated issues to supervisors and other departments, collaborating to identify issue roots and rectify problems.
- Communicated with production team members about quality issues.
- Used calipers and micrometer measuring instruments.
Infantry Team Leader
Marine Corps
07.1997 - 12.2005
- Led infantry team to successfully complete missions by providing clear instructions and efficient communication.
- Utilized tactical expertise to make critical decisions under pressure, leading to successful outcomes in high-stress situations.
- Improved morale within the team by addressing concerns promptly and offering constructive feedback.
- Led fire team during infantry dismounted battle drills and situational training exercises.
- Established defensive positions to protect against enemy forces.
Education
Associate of Applied Science - Criminal Justice
Taylor Business Institute
IL03-2007
Skills
- Prior authorization process
- Medical terminology
- Medical appeals handling
- Insurance verification
- Medical terminology knowledge
- Data entry
- Retro-authorizations
- ICD-10 coding
- CPT coding
Certification
- Electronic Medical Record Management - Wilbur Wright College
- International Classification of Diseases-9 Coding - Wilbur Wright College
- Current Procedural Terminology Coding - Wilbur Wright College
- Law and Ethics for Medical Careers - Wilbur Wright College
Timeline
Prior Authorization Specialist
Fertility Centers of Illinois
12.2011 - 05.2025
Quality Assurance Inspector
RTC INC
08.2007 - 12.2011
Infantry Team Leader
Marine Corps
07.1997 - 12.2005
Associate of Applied Science - Criminal Justice
Taylor Business Institute
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