Noemi Guardian
Stanton,CA
Summary
Experienced Healthcare Support Administrator with strong background in fostering communication and building relationships. Skilled in team collaboration and adept at navigating changing needs to achieve results. Expertise in conflict resolution, project management, and strategic planning. Reliable, adaptable, and focused on driving success through effective partnerships and clear communication.
Overview
13
13
years of professional experience
Work History
Patient Relations Liaison II
Optum
05.2022 - Current
- Served as the primary point of contact, fostering strong relationships between internal teams and external partners.
- Coordinated multiple projects simultaneously, ensuring timely completion and alignment with organizational objectives.
- Enhanced customer satisfaction by swiftly addressing concerns and providing solutions to various issues.
- Supported organizational growth through active participation in networking events, conferences, and professional associations.
- Maintained database systems to track and analyze operational data.
- Developed effective improvement plans in alignment with goals and specifications.
- Generated reports detailing findings and recommendations.
- Managed and conducted outreach related to Medicare eligible patients
Sales Assistant III
Health Net a Centene Corporation
01.2017 - 05.2022
- Interacted daily with Account Executives with all inquiries including but not limited to kit ordering, commissions, member issues, etc
- Managed preparation and execution of co-op marketing dollars for field partners
- Created desktop procedures as it relates to each responsibility assigned
- Examined PAIFs prior to the BRS' review for broker's onboarding process
- Reviewed training materials and work instructions in order to make updates as processes changed
- Performed data entry functions for all producer activity
- Added new Brokers to the Ascend online enrollment tool as well as removed and updated broker details as requested
- Provided resolutions within targeted SLAs for and served as first line of contact for escalated issues
- Executed weekly and monthly reports as well as provided coverage for the Project Manager on the Daily Production Report
- Managed Lead data for Northern California and assigned leads to agents for outreach in Salesforce
- Assigned pre-set appointments based on lead zip code and updated outcomes accordingly
- Provided team lead support and coverage for Manager as needed
- Supported with training new hires to ensure smooth execution of departmental functions
- Performed special projects as assigned
Provider Relations Specialist
Beacon Health Options
01.2016 - 01.2017
- Created monthly E-Blasts for contracted providers on trainings, changes, and any important updates via Constant Contact
- Assisted providers with their claim issues
- Organized and divided the list of providers in the network based on Medical, Medicare or Medi-Medi and plan type
- Created quarterly surveys via Survey Monkey for providers
- Consolidated survey results in order to report to the Director what our strong points were as an organization
Provider Relations Administrator
Medex Healthcare, Inc.
01.2012 - 01.2016
- Provided excellent customer service for injured employees, attorneys, and physicians
- Daily interaction with California providers to assist them in enrolling in the MPN listing
- Receive and handle new provider nominations from various sources, including self-nominations
- Organized, led and sent Excel spreadsheets of 4,000 plus providers currently listed in the network
- Updated and maintained accuracy of database(s) related to Medex Provider Network
- Addressed issues/inquiries as well as provided resolution
- Reported monthly data to leadership related to nominated and re-credentialed providers
- Provided training for new hires for roles and responsibilities
Utilization Review/IMR Specialist
Medex Healthcare, Inc.
01.2012 - 01.2016
- Data entry of incoming referrals to VCMS to include CPT and ICD-9 codes
- Reviewed, analyzed, and assessed doctors reports for logging into VCMS
- Processed referrals based on regulatory turn around times standard for workers compensation
- Participated and supported nursing tasks including faxing, requesting clinical information and created new authorizations
MPN/HCO Coordinator
Medex Healthcare, Inc.
01.2012 - 01.2016
- Communicated and provided exceptional customer service with employers directly
- Met requirements and quotas in order to keep the department numbers up
- Trained several new employees to ensure smooth execution of departmental functions
- Compiled orders of employee handouts for printing via a third part company
Education
High School Diploma -
Robert A. Millikan High School
Long Beach, CA01.2011
Skills
- Ability to multi-task
- Ability to meet deadlines
- Ability to take initiative
- Ability to work independently
- Highly skillful at grasping new things
- Accountable
- Reliable
- Team player
- Organized
- Critical thinker
- Complex problem solving
- Salesforce
- Sales support
- Healthcare industry
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Patient Relations Liaison II
Optum
05.2022 - Current
Sales Assistant III
Health Net a Centene Corporation
01.2017 - 05.2022
Provider Relations Specialist
Beacon Health Options
01.2016 - 01.2017
Provider Relations Administrator
Medex Healthcare, Inc.
01.2012 - 01.2016
Utilization Review/IMR Specialist
Medex Healthcare, Inc.
01.2012 - 01.2016
MPN/HCO Coordinator
Medex Healthcare, Inc.
01.2012 - 01.2016
High School Diploma -
Robert A. Millikan High School
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