Karla Macias
Chino Hills
Summary
Office management professional with track record of optimizing administrative functions and fostering productive work environment. Recognized for strong focus on teamwork and achieving operational success. Reliable and adaptable, with skills in office software, scheduling, and resource management to meet changing needs.
Overview
12
12
years of professional experience
Work History
Office Manager
R&M Transport LLC
01.2024 - 03.2025
- 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 and requisitions and stocking and shipment receiving.
Case Manager
Kaiser Permanente/Rose International
05.2023 - 09.2023
- Investigated and resolved customer service issues
- Filed grievances for patients that were unsatisfied with their health care experience
- Resolved grievances by researching documentation, constructing letters to members and sending detailed information to lead medical staff
- Attended meetings to resolve, improve customer service in all aspects of member's health care experience
Expedited Appeals Coordinator
United Healthcare Group
03.2013 - 12.2022
- Created and maintained a patient care log that noted patient medical history, medications, and diagnoses for authorization approval and appeals
- Organized information by using spreadsheets, databases and word processing applications
- Utilized hospitals, doctor's offices, facilities to monitor and report on individual patient care, including lab results, allergies, and vital signs
- Attended and chaired committee meetings, leading to the adoption of an action plan by the department for Appointment of Representative forms, Power of Attorney, Durable Medical POA
- Maintained case files, verified details with policyholders, acted as intermediary between insurance companies and customers by researching and assessing information to determine claim validity
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions, transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts
Education
Bachelor of Science - Business Management
University of Redlands
Redlands, CA05.2003
Skills
- Bilingual in Spanish
- Customer service
- Time management
- Communication skills
- Computer literacy
- Documentation review
- Problem Resolution
- Active Listening
- Critical Thinking
Timeline
Office Manager
R&M Transport LLC
01.2024 - 03.2025
Case Manager
Kaiser Permanente/Rose International
05.2023 - 09.2023
Expedited Appeals Coordinator
United Healthcare Group
03.2013 - 12.2022
Bachelor of Science - Business Management
University of Redlands
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