Kimberly Andrino-Gonzalez
Downey
Summary
Combine my education with my experience to obtain a position in a professional and established program. Utilize my skills sets for the benefit of the program, the company and the community. Continue to focus on professional growth to ensure new knowledge and skill sets can aid in new roles and job opportunities.
Overview
15
15
years of professional experience
Work History
Patient Relations Representative
Rancho Los Amigos National Rehabilitation Center
Los Angeles County DHS - Health Services
11.2024 - Current
- Duties include interviewing patients or their relatives and/or representatives to obtain identifying information and other eligibility data. Complete 3-way calls to Health Plans for insurance changes. Complete hospital discharge orders by scheduling post hospitalization follow up appointments throughout all DHS facilities. Complete Pediatric IHA outreach. Assist patients with selecting health plans using the Health Care Options website. Serve as a point of contact in member services where patients ask general questions. Provide assistance with calling health plans for transportation needs. Process CERF/NERF request. Assist any new patient with PCP linkage which entails of scheduling IHA appointments. Process PTE’s, permission to enroll forms directly with Health Plans. Financially clear appointments by checking medical eligibility for new patients. Provide medical eligibility answers to Patient Resources Workers.
Patient Resources Worker
Edward Roybal Comprehensive Health Center
Los Angeles County DHS - Health Services
11.2023 - 11.2024
- Assisted patients and families in providing identifying information and financial eligibility data. Scheduled medical appointments for urgent care and clinics as required. Registered patients and entered data into local and web-based systems to assess financial eligibility. Initiated referrals to patient relations for financial coverage assistance and Medi-Cal eligibility. Verified and updated patient demographics during all interactions. Utilized language interpretation services to support patient communication. Identified discrepancies in assignment and empanelment, referring complex cases to patient relations. Updated insurance codes and managed financial clearing for appointments. Scheduled, rescheduled, or canceled appointments based on provider requests and administrative guidelines. Verified coverage and empanelment prior to appointment scheduling. Collected demographic, pharmacy, emergency contact, and insurance information from patients. Forwarded messages to providers and directed callers to appropriate staff for assistance. Communicated relevant patient information through the Orchid message center. Directed self-pay patients to appropriate departments for eligibility assessment for LA County assistance programs. Maintained confidentiality of all patient-related information.
- Department of Health Services
Appointment Clerk
Kaiser Permanente
05.2023 - 08.2023
- Scheduled appointments in a call center setting. Schedule, reschedule, or cancel medical appointments using standardized workflows/procedures. Verify and update patient demographics at any/all points of contact with the patient. Understand and utilize scheduling guidelines and rules when scheduling appointments. Take forward messages to providers and/or transfer callers to appropriate facility staff for assistance.
Patient Resources Worker, Call Center Agent
Edward Roybal Comprehensive Health Center
Los Angeles County DHS - Health Services
07.2021 - 05.2023
- Received incoming calls for public health center in call center environment. Assisted patients with inquiries regarding financial and medical eligibility. Scheduled medical appointments and assessed patient financial eligibility. Updated patient demographics during all interactions. Identified discrepancies in assignments and submitted empanelment requests. Updated insurance codes as necessary. Processed financial clearing for all appointments. Communicated messages to providers and nursing staff.
Community Health Worker, Case Manager
Women's Reintegration Services & Education
Los Angeles County DMH- Mental Health
06.2020 - 07.2021
- Provided case management support to individuals transitioning from the criminal justice system to facilitate community reintegration. Collaborated with clinicians to coordinate care effectively. Conducted client interviews to identify potential program linkages and secure necessary information. Assisted clients in accessing social programs, including cash assistance, healthcare, food assistance, transportation, and housing, tailored to individual needs. Supported clients in attending essential medical and non-medical appointments. Facilitated conference calls with agencies such as SSI and DPSS as required. Made regular follow-up calls to clients to assess ongoing case management needs. Aided clients in improving, maintaining, or restoring their functional levels. Accompanied clinicians on outreach visits to locate clients who were unaccounted for. Utilized local county inmate locator websites to track missing clients. Documented and billed rehabilitation case management and consultation notes using the IBHIS system. Recorded client interactions in IBHIS promptly.
- Department of Mental Health
Community Health Worker, VFC Field Rep
Vaccine Preventable Disease Control Program
Los Angeles County DPH - Public Health
07.2017 - 06.2020
- Visited schools across Los Angeles County to verify compliance of student immunization records with school regulations. Assisted in contacting schools and childcare facilities listed for assessment delinquency. Provided training sessions on immunization requirements to school and childcare staff. Responded to inquiries from schools, childcare facilities, and medical clinics regarding immunization protocols. Conducted interviews with school personnel and nurses to understand immunization record-keeping practices. Supported nursing unit in follow-ups resulting from compliance visits with VFC providers. Aided VFC provider clinics in addressing storage, handling, and vaccine ordering concerns through visits, emails, or phone calls. Conducted site visits to various doctor offices in Los Angeles County enrolled in the VFC program, providing training on proper storage and handling procedures. Audited refrigeration units to ensure compliance with VFC standards. Collaborated with medical office staff to resolve any questions regarding immunization processes.
Medical Assistant
AppleCare Medical Group
07.2011 - 06.2017
- Achieved seamless patient registration and appointment scheduling, contributing to efficient office operations. Enhanced patient care by accurately maintaining medical records and ensuring HIPAA compliance. Facilitated insurance eligibility verification with major providers, optimizing patient access to services. Improved financial processes by effectively collecting copays and managing electronic transaction entries.
Education
High School Diploma -
Opportunities for Learning
01-2006
Associate of Science - Sociology
Compton Community College
Compton, CA06-2023
Skills
- Bilingual in English/Spanish
- Maintains strict confidentiality
- Strong work ethic
- Deadline driven
- Skilled multi-tasker
- Detail oriented
- Punctual
- Ability to work under pressure
- Team player
- Positive attitude
Timeline
Patient Relations Representative
Rancho Los Amigos National Rehabilitation Center
11.2024 - Current
Patient Resources Worker
Edward Roybal Comprehensive Health Center
11.2023 - 11.2024
Appointment Clerk
Kaiser Permanente
05.2023 - 08.2023
Patient Resources Worker, Call Center Agent
Edward Roybal Comprehensive Health Center
07.2021 - 05.2023
Community Health Worker, Case Manager
Women's Reintegration Services & Education
06.2020 - 07.2021
Community Health Worker, VFC Field Rep
Vaccine Preventable Disease Control Program
07.2017 - 06.2020
Medical Assistant
AppleCare Medical Group
07.2011 - 06.2017
High School Diploma -
Opportunities for Learning
Associate of Science - Sociology
Compton Community College