KAREN FLORES
Temecula
Summary
Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.
Overview
12
12
years of professional experience
Work History
ELIGIBILITY TECHNICIAN I
County of Riverside DPSS
01.2025 - Current
- Developed comprehensive case files for each client, documenting all relevant information needed for eligibility determinations and audits.
- Participated in professional development opportunities to stay current on changes in state and federal regulations affecting program administration.
- Reduced errors in benefit calculations by conducting thorough reviews of applicant financial information, ensuring consistency with program guidelines.
- Contributed positively to a collaborative work environment by sharing knowledge, best practices, and insights into improving overall team performance.
- Adhered to all established timelines for case processing, consistently meeting or exceeding performance targets set by management.
- Provided ongoing support to clients throughout the eligibility review process, maintaining open lines of communication for updates and inquiries.
- Addressed escalated client concerns professionally and efficiently, working to find solutions that maintained program integrity while meeting client needs.
MEDICAL OFFICE CLERK
Naval Hospital Camp Pendleton
09.2024 - 01.2025
- Increased overall efficiency of the office through implementation of improved filing systems for easy access to vital documents.
- Performed general clerical tasks such as photocopying, faxing, and data entry with high accuracy ensuring efficient office operations.
- Reduced wait times for patients with efficient check-in and check-out procedures, ensuring a positive experience.
- Assisted in the training and orientation of new hires to ensure seamless integration into the medical office team.
- Managed incoming calls professionally, directing inquiries to appropriate personnel while minimizing interruptions to office productivity.
- Managed specimen sample handling, receiving, storage and inventory.
- Logged samples correctly into computerized tracking system.
- Demonstrated competence in collecting lab samples for testing.
HIM ANALYST
UHS
11.2021 - 09.2024
- Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Scanned medical records in digital format for easy retrieval and accessibility.
- Reviewed charts and flagged incomplete or inaccurate information.
- Enhanced the overall quality of patient care by ensuring that all medical records were up-to-date, comprehensive, and easily accessible for healthcare professionals.
- Enhanced data security by implementing strict protocols for accessing and managing sensitive patient information.
- Ensured ongoing adherence to industry standards by staying current on changes in medical coding practices and updating internal systems accordingly.
OFFICE MANAGER
Rancho Counseling Center
02.2020 - 07.2021
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
- Oversaw office inventory activities by ordering.
- Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
- Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
- Assisted in the recruitment process, conducting interviews and onboarding new employees to promote a seamless integration into the team dynamic.
Medical Records Director
Aviara Healthcare
04.2019 - 12.2019
- Oversaw secure transfer of patient records to other health care providers to support requests and authorizations.
- Evaluated requests for information and maintained and tracked releases to comply with federal and state laws.
- Developed and implemented record storage and retrieval system to comply with record retention laws and maintain accessibility.
- Created and maintained safeguards against unauthorized access and use of computer-based medical records.
- Reviewed open and closed records to comply with medical record documentation policies and reported findings to nursing services director.
- Abstracted information from records as authorized or requested by insurance companies and other third-party payers.
- Analyzed quality control assessment findings and developed and implemented methods to improve performance.
- Ensured compliance with HIPAA regulations by regularly auditing and updating policies and procedures regarding patient information security.
Medical Records Clerk
Neighborhood Healthcare
01.2013 - 04.2019
- Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Scanned medical records in digital format for easy retrieval and accessibility.
- Maintained patient records systems by archiving, scaning and indexing important documents and files.
- Supported medical staff by providing organized and accurate medical records.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Responded to patient inquiries to provide information and details of medical records.
Education
Bachelor of Science - Marketing, Social Media Concentration
Southern New Hampshire University
05-2029
Skills
- Management
- Medical Scheduling
- Microsoft Excel
- Analysis skills
- Interviewing techniques
- Effective communication skills
- Insurance Verification
- Medicaid
- Confidentiality
- Cross-cultural sensitivity
- Microsoft office
- Social services
- Benefits administration
Timeline
ELIGIBILITY TECHNICIAN I
County of Riverside DPSS
01.2025 - Current
MEDICAL OFFICE CLERK
Naval Hospital Camp Pendleton
09.2024 - 01.2025
HIM ANALYST
UHS
11.2021 - 09.2024
OFFICE MANAGER
Rancho Counseling Center
02.2020 - 07.2021
Medical Records Director
Aviara Healthcare
04.2019 - 12.2019
Medical Records Clerk
Neighborhood Healthcare
01.2013 - 04.2019
Bachelor of Science - Marketing, Social Media Concentration
Southern New Hampshire University
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