Summary

Overview

Work History

Education

Skills

Languages

Timeline

Silvia CASTRO

Ramona

Summary

Results-driven professional provides customers with tailored solutions to meet needs. Successfully establishes relationships with customers and delivers quality service. Agile individual with excellent communication and customer service skills.

Overview

years of professional experience

Work History

INSURANCE SPECIALIST

Valley Radiology Consultants Medical Group

02.2020 - Current

Maintained high standards of customer service by building relationships with clients.
Resolved discrepancies in insurance payments by collaborating with carriers.
Followed up on denials, late payments, extensions and other special circumstances.
Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
Researched and resolved routine and complex issues while maintaining confidentiality of patient finances, records, and health statuses.
Acted as subject matter expert, answering internal and external questions and inquiries.
Communicated effectively with members of operations, finance and clinical departments.
Employed microsoft excel to document and track customer account details.
Responded to customer calls swiftly to resolve issues and answer questions.
Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
Built relationships with clients using active listening and issue resolution to provide excellent service.
Investigated and processed claims swiftly to keep customers satisfied.
Developed detailed microsoft excel reports for management to track performance.
Analyzed customer needs to provide customized insurance solutions.

PATIENT CARE & SURGERY COORDINATOR

SAN DIEGO VASCULAR CENTER

08.2017 - 02.2020

Managed office logistics by scheduling appointments, maintaining files and collecting payments.
Coordinated testing, labs and other diagnostic data for proper clearance prior to surgery.
Verified insurance coverage and benefits and communicated directly with patient for timely scheduling of clinic appointment and surgery procedure.
Collaborated with patient, referring physician and surgical specialist to coordinate pre- and post-operative care for surgical procedures.
Documented and collected patient data in microsoft word and excel to maintain accuracy and security.
Counseled patient about personal financial responsibility and collaborated with billing to resolve patient accounts.
Expertly managed planning, scheduling, and coordination of outpatient procedures.
Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
Verified insurance coverage and obtained pre-authorizations.
Educated patients about surgeries and provided treatment plan documentation.
Coordinated with facilities to set up surgeries for three vascular surgeons.
Collated pre-operative lab and imaging results to facilitate surgery planning.
Performed various administrative tasks for three vascular surgeons.
Scheduled patient appointments in respective doctors' calendars.
Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
Prepared and processed patient referrals and transfer

Patient Financial Counselor

ARCH MEDICAL GROUP

05.2015 - 07.2017

Verified patient insurance eligibility and entered patient information into system.
Processed payments using cash and credit cards, maintaining accurate records of transactions.
Provided excellent customer service to patients and medical staff.
Created microsoft excel documents for reporting and tracking purpose.
Created microsoft word documents to implement effective physician to patient communication.
Engaged with patients to provide critical information.
Facilitated communication between patients and various departments and staff.
Organized patient records and database to facilitate information storage and retrieval.
Applied administrative knowledge and courtesy to explain procedures and services to patients.
Compiled and maintained patient medical records to keep information complete and up-to-date.
Liaised between patient, doctor and insurance provider to smooth claims processes.
Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
Resolved customer complaints using established follow-up procedures.
Helped address client complaints through timely corrective actions and appropriate referrals.
Cross-trained existing employees to maximize team agility and performance.
Communicated clearly with employees, suppliers and stakeholders to keep everyone on same page and working toward established business goals.
Maintained professional demeanor by staying calm when addressing unhappy or angry customers.

Patient Care Coordinator & Assistant Manager

Kevin L. Metros, Orthopedic Surgery

07.2004 - 04.2015

Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
Maintained confidentiality of patient data and condition to safeguard health information.
Monitored and analyzed business performance to identify areas of improvement and make necessary adjustments.
Assisted in organizing and overseeing assignments to drive operational excellence.
Performed as subject matter expert for case management processes.
Trained in-house users on advanced functionality of MS Word and Excel.
Formatted business documents using Microsoft products (excel & word).
Translated business documents from English to Spanish.
Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
Communicated clearly with employees, suppliers and stakeholders to keep everyone on same page and working toward established business goals.
Worked with patients to schedule tests and procedures.
Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
Monitored patient health records for accuracy to meet compliance with healthcare guidelines.
Assisted patients with coordinating short and long-term care.
Verified patient insurance eligibility and entered patient information into system.
Answered incoming calls, scheduled appointments and filed medical records.
Processed payments using cash and credit cards, maintaining accurate records of transactions.
Trained new staff on filing, phone etiquette and other office duties.
Applied administrative knowledge and courtesy to explain procedures and services to patients.
Helped address client complaints through timely corrective actions and appropriate referrals.
Recommended service improvements to minimize recurring patient issues and complaints.

Dealer Relations Specialist

Household Automotive/HSBC

10.1998 - 10.2003

Improved existing reporting by researching data sources, compiling data and designing output.
Produced quality reports formatted in compliance with data quality standards.
Utilized in-depth analysis and creative problem solving to troubleshoot reporting issues.
Maintained ongoing schedule and documentation for all reporting procedures.
Automated multiple reporting tasks through creation of reporting tools.
Applied advanced Excel functions and filters to support infrastructure.
Served as subject matter expert on call center performance metrics analysis, design, development.
Supported efficiency and data integrity by monitoring control documentation of reporting procedures.
Enhanced data integrity by applying meticulous attention to detail when reviewing and analyzing data maintenance processes.
Developed customized reports, summarizing and presenting data in visually appealing format.
Managed large volumes of data efficiently and with great care on daily basis.
Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
Audited and corrected billing and posting documents for accuracy.
Utilized various software programs to process customer payments.

Education

Bachelor of Science - Accounting And Business Management

Stevens-Henager College

Salt Lake City, UT

08.2021

Certificate of Completion - Microsoft Word/Excel/Power Point

New Horizons Computer Learning Center

San Diego, CA

04.2003

High School Diploma -

Ramona High School

Ramona, CA

06.1994