To find a long-term position where I can contribute my knowledge, skills, and great positive energy to the organization. I would like to continue to provide valuable service both to the patient and the organization.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Member Service Representative
Molina Healthcare Inc
09.2013 - 09.2025
Placing outbound calls to welcome new members into their health plan, Medicaid, and Marketplace plans
Provide an overview of benefits to members according to plan type, as well as assisting with scheduling appointments.
Scheduling Transportation for Medicaid members
Taking inbound calls from providers and members
Filing complaints for members
Taking crisis calls
Claims training for CA
Taking Provider calls and assisting with verifying Eligibility, Benefits, and Authorizations
Verifying CPT codes are covered
Assisting in scheduling appointments for members, scheduling transportation
Meeting monthly adherence and Quality scores at or above 98%
Attendance at 100%
Training new agents
Patient Coordinator
United Medical Imaging of Maywood
08.2010 - 12.2012
Verification of insurance eligibility of HMO, PPO, Medi-Cal, Medicare plans
Checking in patients and prepare charts.
Collect co payments and deductibles if applicable.
Schedule appointments
Verify CPT codes and modify codes if needed.
Give patient instructions for CT exams.
Fax medical records
Education
Adult School - undefined
Downey
01.2010
High school - undefined
Locke High
01.2002
Skills
Bi-lingual in Spanish
Salesforce, CRM, and QNXT program
Claims training
Knowledge of Marketplace and Medicaid plans all states
Lead Customer Service Representative – Account Coordinator at Advanced Marketing & DistributionLead Customer Service Representative – Account Coordinator at Advanced Marketing & Distribution