Karla Figueroa
Long Beach
Summary
Professional with background in healthcare coordination and patient management. Skilled in streamlining inpatient processes, ensuring seamless communication between medical teams, and providing exceptional patient support. Strong focus on collaboration, adaptability, and achieving measurable results. Known for reliability, problem-solving abilities, and maintaining high standards in dynamic healthcare environments.
Overview
9
9
years of professional experience
Work History
Inpatient Coordinator I
Heritage Provider Network
07.2022 - Current
- Improved patient satisfaction by coordinating efficient admissions, discharges, and transfers for inpatient care.
- Communicate to the Medical Director or designee, immediately any admissions to non-contracted hospitals
- Provide face sheet to Medical Director or designee, immediately upon receipt and eligibility check
- Assist Inpatient Care Managers with planning for discharge by generating authorizations and scheduling appointments for services needed within 7 days of discharge
- Communicate with High Risk/outpatient department(s) any services identified upon discharge that are necessary beyond 7 days after discharge
- Execute all post discharge needs (ie: PCP, Specialist appts, diagnostic studies, etc)
- All other duties as directed by management
Customer Service Superuser/ Revenue Cycle
Collaborative Imaging LLC
09.2021 - 07.2022
- Assist patients with billing issues/concerns
- Review/update coding issues
- Issue refunds and/or follow up on collections notices
- Partnered with hospital leadership to identify revenue cycle challenges, developing strategic solutions that directly addressed problem areas.
- Safeguarded sensitive patient data through strict adherence to HIPAA guidelines and implementation of secure record-keeping practices.
- Reduced claim denials and rejections by conducting thorough audits and addressing discrepancies prior to submission.
- Collaborated with insurance providers to expedite claims processing and secure timely payments for services rendered.
Team Member
Jack in the Box
06.2016 - 03.2020
- Kept work areas clean, organized, and safe to promote efficiency and team safety.
- Worked scheduled shifts and remained available to work during coworker absences, holidays, and busy periods.
- Developed strong customer service and product knowledge skills to enhance individual and team performance.
- Operated register to process payments and collect cash payment for order totals.
- Worked different stations to provide optimal coverage and meet production goals.
Customer Service Representative / Dispatch / Billing
Associated Global Systems
11.2018 - 11.2019
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
Member Service Representative
Molina Healthcare
01.2018 - 10.2018
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
- Verified customer identification and documentation for compliant transactions.
Education
Medical Billing and Coding -
UEI College
Gardena, CA04.2022
High School Diploma -
Paramount High School
Paramount, CA06.2017
Skills
- Customer Service
- Microsoft Office (Excel, Outlook, PowerPoint, Word)
- Insurance Verification
- Medicare, Medicaid And Third Party Billing
- HIPAA compliance
- Scheduling appointments
- Clinical documentation
- Discharge planning
- Utilization review
- Patient care
Languages
Spanish
Native or Bilingual
Timeline
Inpatient Coordinator I
Heritage Provider Network
07.2022 - Current
Customer Service Superuser/ Revenue Cycle
Collaborative Imaging LLC
09.2021 - 07.2022
Customer Service Representative / Dispatch / Billing
Associated Global Systems
11.2018 - 11.2019
Member Service Representative
Molina Healthcare
01.2018 - 10.2018
Team Member
Jack in the Box
06.2016 - 03.2020
Medical Billing and Coding -
UEI College
High School Diploma -
Paramount High School
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