ROCIO DOMINGUEZ
Los Angeles
Summary
Dynamic individual with hands-on experience in [Area of expertise] and talent for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.
Overview
6
6
years of professional experience
Work History
Enrollment Specialist I
APLA Health and Wellness
10.2021 - Current
- Screen patients for eligibility to enroll/ re-enroll in Medi-Cal, Medicare, My Health LA, Ryan White, ADAP, Covered California, and PrEP-AP
- Work alongside with primary care providers, nurses, and other clinic staff
- Assist the Prep Navigator with PrEP AP enrollment by verifying patient’s insurance
- Help patients become established patients by verifying and fixing their insurance by calling Health insurance plans representatives
- Serve as a direct resource for patients with questions or problems related to their health insurance or county programs
- Document every interaction with patient and maintain information updated for every visit
- Work with case managers or nurses from other agencies to help clients become established patients at any of our APLA clinic locations
- Follow up with patients for applications
- Collaborate with APLA’s outreach staff to help potential patients transfer to APLA as their primary provider
- Help newly diagnosed HIV patients enroll in the County program, Ryan White and ADAP to help get coverage for their medical visits and medication for their HIV
- Enrolled and renewed undocumented patients into My Health LA for them to have access to a primary care doctor and dentist for a full year
- Certified as an Enrollment Counselor for Covered California to assist patient during the open enrollment period
- Troubleshoot patient’s accounts with our billing department and referral department
- Keep updated with any new changes related to patient’s insurance to avoid any gap in coverage
Direct Care Staff
Esperanza Services
10.2020 - 05.2021
- Worked with adolescents and elderly clients with developmental disabilities with daily activities
- Responsible for 5 to 6 clients both young adolescents and elderly with development
- Reported changes to the Regional Center and case manager
- Used crisis intervention techniques to work with clients under stressful environments
- Maintained a healthy home environment for each responsible client
- Monitored mental and emotional behavior of clients
- Took clients to medical appointments
- Submitted biweekly and quarterly reports
- Attended meetings with case manager to discuss about client progress and important needs for each client
Eligibility Coordinator
RISARC
08.2019 - 09.2020
- Screened patients for Medi-Cal and Covered California eligibility over the phone or at contracted hospitals
- Knowledgeable about Medi-Cal requirements in regards to income, household, and property guidelines (Magi/FPL)
- Educated patients about the benefits of applying for Medi-Cal as either primary or secondary insurances to cover any pending medical expenses or bills
- Submitted Medi-Cal applications on behalf of the patients as the authorized representative
- Responsible to follow up for 100 to 200 Medi-Cal pending cases monthly
- Followed up with patients and/or families for missing verifications requested by the County Eligibility Worker
- Helped eligibility workers and county supervisors obtain important patient information to help expedite Medi-Cal applications for patients in critical conditions or in ICU
- Utilized company’s case management program to document every action taken on patient’s account
- Updated patient’s information and insurance on their chart
- Point of contact for patients to obtain status on their pending Medi-Cal case
- Communicated directly with County Eligibility workers, County supervisors, and deputies for updates on a Medi-Cal case
- Prepared county appeals for denied Medi-Cal cases
- Field Representative at Good Samaritan Hospital (Back up)
- Obliged to company HIPPA guidelines
- Screened intubated patients over the phone for Medi-Cal and Covered California eligibility
- Updated nurses and doctors at either hospital and skilled nursing facilities for Medi-Cal status
- Worked specifically on patient accounts admitted for Covid with supervisor on hospital accounts with the highest accounts
- Worked directly with eligibility workers for patients admitted due to Covid
Education
Bachelor in Art -
CALIFORNIA STATE UNIVERSITY MONTEREY BAY
05.2019
Skills
- Data entry skills
- Customer service expertise
- Provider relations
- Benefits administration
- Client relationship building
- Client advocacy
- Interpersonal relations
- Workflow optimization
- Cross-functional teamwork
Timeline
Enrollment Specialist I
APLA Health and Wellness
10.2021 - Current
Direct Care Staff
Esperanza Services
10.2020 - 05.2021
Eligibility Coordinator
RISARC
08.2019 - 09.2020
Bachelor in Art -
CALIFORNIA STATE UNIVERSITY MONTEREY BAY
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