Mario Gomez
San Francisco
Summary
Dynamic Access Coordinator at HealthRight 360 with expertise in HIPAA compliance and exceptional customer service. Proven ability to streamline scheduling and enhance communication, resulting in improved client satisfaction. Bilingual communicator skilled in resolving complex inquiries, demonstrating empathy and cultural sensitivity while collaborating effectively with cross-functional teams.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Access Coordinator
HealthRight 360
10.2024 - Current
- Assisted in scheduling and coordinating service appointments for clients.
- Supported team with documentation and data entry to streamline processes.
- Collaborated with staff to ensure timely communication of client needs.
- Learned procedures for handling access requests and client inquiries efficiently.
- Adapted quickly to new software tools for managing client information.
- Provided excellent customer service by addressing client concerns promptly.
- Collaborated with clinical teams to ensure appropriate patient placement based on acuity and service requirements.
Appeals Analyst
Aetna
07.2018 - 01.2023
- Analyzed appeal cases to determine eligibility and compliance with regulatory guidelines.
- Collaborated with cross-functional teams to gather necessary documentation for appeals processing.
- Assisted in reviewing and interpreting policies related to claims and appeals management.
- Maintained accurate records of appeal statuses using case management software.
- Provided support in drafting appeal letters and notifications for claimants.
- Streamlined internal communication processes to enhance efficiency in case handling.
Bilingual Customer Service Representative
Aetna
09.2016 - 07.2018
- Assisted customers in both English and Spanish, resolving inquiries efficiently and enhancing satisfaction.
- Managed customer accounts using CRM software, ensuring accurate information and updates.
- Trained new staff on bilingual communication techniques and customer service protocols.
- Collaborated with cross-functional teams to streamline processes and improve service delivery.
- Assisted customers with Spanish-language inquiries in a timely and professional manner.
- Enhanced customer satisfaction by addressing and resolving complex inquiries in both English and Spanish languages.
Education
Bachelor of Arts - Arts
California State University, Fresno
Fresno, CA06-2015
Skills
- Expertise in HIPAA compliance
- Customer service expertise
- Exceptional organization
- Adaptable mindset
- Empathy and patience
- Proficient bilingual communication
- Cultural sensitivity
- Problem-solving skills
- Resolving issues
- Scheduling coordination
Certification
- Salvation Army Haborlight Graduate - October 2024
Languages
Spanish
Full Professional
Timeline
Access Coordinator
HealthRight 360
10.2024 - Current
Appeals Analyst
Aetna
07.2018 - 01.2023
Bilingual Customer Service Representative
Aetna
09.2016 - 07.2018
Bachelor of Arts - Arts
California State University, Fresno
Similar Profiles
Annette IwebemaAnnette Iwebema
Human Resources Business Partner II at HealthRIGHT 360Human Resources Business Partner II at HealthRIGHT 360
Emmanuel AbarquezEmmanuel Abarquez
Health Worker at HealthRIGHT 360Health Worker at HealthRIGHT 360
Jessica MendozaJessica Mendoza
Compliance Coordinator at Prototypes: A Program of Healthright 360Compliance Coordinator at Prototypes: A Program of Healthright 360
M. Sean SilverM. Sean Silver
Tour Guide at Dylan's ToursTour Guide at Dylan's Tours
Ava Hult-FalkAva Hult-Falk
Babysitter at Mar GudimBabysitter at Mar Gudim