Carol Garcia
Oxnard
Summary
Dynamic Patient Referral Coordinator with extensive experience at County Of Ventura - Health Care Agency, excelling in referral management and patient communication. Proven track record in securing timely authorizations and appointments, while maintaining HIPAA compliance. Adept at problem-solving and attention to detail, ensuring seamless patient care and efficient referral processing. Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handle complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.
Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
30
30
years of professional experience
Work History
Patient Referral Coordinator
County Of Ventura - Health Care Agency
Ventura
06.2021 - Current
- Provided timely follow up on all outstanding referrals ensuring they are completed within required timelines.
- Request prior authorizations, schedule, and confirm appointments.
- Fax external referrals to tertiary care hospitals.
- Communicate with the parent or patient regarding the referral or procedure.
- Document in the patient's chart.
- Verify benefits prior to submitting a referral.
- Make telephone calls to outside providers to find the appropriate care for the patient.
- Schedule MRIs, ultrasounds, swallow studies, and CTs.
- Help out as needed in the clinic.
- Work and communicate closely with nurses and physicians to make sure the patient's referral is submitted in a timely manner.
Patient Referral Coordinator
Pediatric Diagnostic Center
Ventura
04.2015 - 06.2021
- Collaborated with internal departments such as clinical staff, billing department and health insurance companies to ensure efficient processing of referrals.
- Provided timely follow up on all outstanding referrals ensuring they are completed within required timelines.
- Performed administrative tasks such as filing documents related to patient's referrals.
- Utilized various software programs such as Microsoft Office Suite and Electronic Medical Records systems.
- Compiled reports detailing the number of referrals processed on a daily, weekly, monthly basis.
- Maintained a database of referral information and tracked referrals received and sent out.
- Assisted in the coordination of patient referrals to other medical providers.
- Provided customer service support by responding promptly to inquiries from patients, families and other healthcare professionals.
Medical Billing Coordinator
Community Memorial Health System
Ventura
11.2006 - 12.2014
- Assessed medical codes on patient records for accuracy.
- Assigned charges and payments for medical procedures.
- Reviewed medical records to meet insurance company requirements.
- Reviewed account information to confirm that the patient and insurance information were accurate and complete.
- Filed and submitted insurance claims.
- Reviewed claims for accuracy and appropriateness.
- Utilized electronic charge capture systems to consolidate and streamline the billing process.
- Reviewed received payments for accuracy, and applied them to the intended patient account.
- Reconciled clinical notes, patient forms, and health information for compliance with HIPAA rules.
- Verified final claim submissions by comparing account charges with documentation.
Assistant Office Manager
Burnwall Physical Therapy Clinic
Oxnard
08.1995 - 09.2006
- Provided administrative support to senior management staff.
- Responded promptly to customer inquiries via phone or email.
- Maintained a calendar of events, meetings, conferences, appointments.
- Tracked employee attendance records and vacation requests.
- Performed additional tasks assigned by senior management staff.
- Supervised Billing Department
- Collections & Accounts receivable
- Settled workers compensation claims & personal injury liens
- Trained new staff
- Translated for Therapists when needed
- Drafted meeting agendas
- Recruited, trained and developed dynamic administrative team, supporting all corporate growth and productivity objectives
Education
High School Diploma -
Buena High School
Ventura06-1980
Some College (No Degree) - Medical Terminology
Ventura College
Ventura, CASkills
- Referral management
- Prior authorization
- Electronic medical records
- Data entry
- Appointment scheduling
- Benefit verification
- Patient communication
- Problem solving
- Attention to detail
- Referral tracking
- Medical terminology
- Insurance verification
- Maintaining confidentiality
- Administrative support
- Scheduling appointments
- HIPAA compliance
- Multitasking
- Patient care
Languages
Spanish
Professional
Timeline
Patient Referral Coordinator
County Of Ventura - Health Care Agency
06.2021 - Current
Patient Referral Coordinator
Pediatric Diagnostic Center
04.2015 - 06.2021
Medical Billing Coordinator
Community Memorial Health System
11.2006 - 12.2014
Assistant Office Manager
Burnwall Physical Therapy Clinic
08.1995 - 09.2006
High School Diploma -
Buena High School
Some College (No Degree) - Medical Terminology
Ventura College
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