Elaine Torrez
Apple Valley,CA
Summary
Seeking a position where I can utilize my skills and abilities as well stimulate future career advancements.
Overview
18
18
years of professional experience
Work History
Utilization Review Assistant
Loma Linda University Health
05.2024 - Current
- Responsible for verifying eligibility and benefits for both physician and hospital base services, entering patient demographic information and confirming billing information
- Initiates and produces authorization for all ordered services and documents incoming authorizations and other correspondences
- Responsible for obtaining authorizations for patient discharging
- Works closely with clinics and obtaining authorizations for follow up care for patient care
Insurance Verifier/Financial Counselor
Desert Valley Hospital
03.2020 - 05.2024
- Responsible for determining patient liability based on benefits and advises patient of their liability prior to scheduled elective procedures
- Notifies patient of financial responsibility; collection arrangement is made prior to services rendered for all elective care
- Verifies insurance eligibility, and benefits for emergent and urgent admissions, procedures or other services ensuring communication of patient responsibility to the patient or responsible party
- Verifies and secures accurate patient demographic and insurance information, updating patient account information as needed
- Assists patients in deciding as needed for patient responsibility by time of discharge for emergent or urgent services
- Screens and refers patients for possible linkage to state, county or other government assistance programs as well as Charity or Discounts as per the facility Charity and Discount policies
- Works closely with Case Management in securing Medicaid/Medical treatment authorizations as needed
- Maintains effective communication skills, including verbal, written and telephone
- Proficient in mathematical skills
ER Admitting Clerk
Victor Valley Global Medical Center
08.2019 - 01.2020
- Ability to communicate effectively, both verbally and non-verbally
- Demonstrate strong interpersonal skills, ability to interact diplomatically and to maintain a professional demeanor with all customers
- Ability to discuss personal and financial matters with patients/or representatives
- Good problem solving and process efficiency skills
- Knowledge of insurance benefits, covered services, billing and collection procedures for all government insurance
- General knowledge of office procedures and ability to utilize resources in an organized manner
- Performs all other duties as assigned
Insurance Verification Specialist/ Referral Coordinator
Loma Linda University Health
01.2007 - 07.2019
- Verify and obtain benefits for patients scheduled for in and outpatient procedures
- Notify insurance companies and IPA's of patients admit in a timely manner
- Works with Case Management on in house and emergency room account requesting SAR'S from CCS for pediatric patients seen in the emergency room
- Request TAR's from Medi-cal for patients seen in the emergency room
- Follow up on all authorizations requested in a timely manner for billing
Education
Bachelors Of Nursing - Nursing
Nightingale College
02.2025
Associate Of Applied Science - Nursing
Barstow Community College
Barstow, CA01.2023
Certificate -
CAAHEP Accredited Southern California Regional Occupational Center
01.2004
Skills
- Patient Assessment
- Prior Authorization
- Discharge Planning
- Patient Referral
- Customer Service Skills
- Patient Case Management
- Utilization Management
- Data Entry
- Meditech
- Microsoft Office
- Scheduling
- Epic
Languages
Spanish
Native or Bilingual
Timeline
Utilization Review Assistant
Loma Linda University Health
05.2024 - Current
Insurance Verifier/Financial Counselor
Desert Valley Hospital
03.2020 - 05.2024
ER Admitting Clerk
Victor Valley Global Medical Center
08.2019 - 01.2020
Insurance Verification Specialist/ Referral Coordinator
Loma Linda University Health
01.2007 - 07.2019
Certificate -
CAAHEP Accredited Southern California Regional Occupational Center
Bachelors Of Nursing - Nursing
Nightingale College
Associate Of Applied Science - Nursing
Barstow Community College
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