MARIA LOZA
Pomona
Summary
Experienced with managing referral systems and client coordination. Utilizes strong communication skills to ensure accurate and timely referrals. Track record of effective problem-solving and adaptability, contributing to team success.
Overview
9
9
years of professional experience
Work History
Referral Specialist
Carelon
12.2024 - Current
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Obtained prior authorization for a wide variety of procedures from different specialties.
- Entered authorization data using Next Gen to document referrals and results.
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
Dental Front Office Coordinator
Kanoknuch Shiflett Pediatric DDS
09.2017 - 01.2023
- Reduced no-show rates through timely and effective appointment reminders and confirmations.
- Understood dental terminology and insurance breakdowns.
- Supported dental team members with accurate record-keeping, ensuring up-to-date documentation of treatment plans and progress notes.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Completed office opening and closing procedures.
- Coordinated patient scheduling, check-in, check-out and collecting co-payments for billing.
- Used Dentrix to schedule appointments for dental visits and procedures.
Receptionist/Scheduler
Sunny Hills Behavioral Health
10.2016 - 05.2017
- Managed high call volume while maintaining professionalism and accuracy when gathering patient information for appointment bookings.
- Provided compassionate support to patients during check-in/check-out process, addressing concerns and answering questions as needed.
- Obtained payments from patients and scanned identification and insurance cards.
- Updated demographics regularly on electronic health record systems ensuring accuracy and up-to-date information accessible during visits.
- Aided with prescription refill requests.
- Ran patient's insurance to ensure eligibility.
Front assistant | Externship
NNE Medical Supply and Equipment
02.2016 - 03.2016
- Posted payments on current accounts, verify Medicare insurance, checked eligibility.
- Confirmed equipment deliveries.
Education
Medical Billing and Coding Diploma - Medical Billing
Carrington College
Pomona06-2014
High school Diploma - undefined
Skills
- Customer service
- Data Entry
- Coding
- Insurance verification and electronic billing
- Appointment scheduling
- Collections
- Medical/Dental Terminology
- ICD-10, CPT, HCPCS
- payment posting
- Next Gen, Dentrix, Ally EHR knowledge
- HIPPA certification
- Prior authorizations
- Referrals
Languages
Spanish
Native or Bilingual
Timeline
Referral Specialist
Carelon
12.2024 - Current
Dental Front Office Coordinator
Kanoknuch Shiflett Pediatric DDS
09.2017 - 01.2023
Receptionist/Scheduler
Sunny Hills Behavioral Health
10.2016 - 05.2017
Front assistant | Externship
NNE Medical Supply and Equipment
02.2016 - 03.2016
High school Diploma - undefined
Medical Billing and Coding Diploma - Medical Billing
Carrington College
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