Summary
Overview
Work History
Education
Skills
Timeline
Generic

Viviana Torres

Sacramento

Summary

Bilingual Medical Administrative Professional with over 7 years of experience in referral coordination, prior authorizations, and patient access across diverse healthcare settings. Skilled in navigating insurance requirements including HMO, PPO, Medicare and Medi-Cal while ensuring timely processing of referrals and specialty care.

Overview

8
8
years of professional experience

Work History

Service Dispatcher

Mark Three Construction
Sacramento
06.2023 - Current
  • Coordinate daily scheduling and dispatching of crews across HVAC, plumbing, and electrical services.
  • Communicate work orders and updates between supervisors, field staff and customers.
  • Maintain accurate records of service requests, completed jobs, and inventory.
  • Position demonstrates transferable skills in scheduling, problem-solving, and customer service.

Medical Referral Specialist I

Centene
Sacramento
06.2022 - 01.2023
  • Processed outpatient, DME, pre-elective, and home health prior authorization requests with 100% adherence to compliance standards.
  • Handled an average of 23+ cases per day, meeting and exceeding productivity goals.
  • Coordinated with providers to collect medical records and verify information, ensuring accurate and timely processing.
  • Verified eligibility and benefits, processed faxes and web requests, and maintained precise EMR documentation.
  • Supported appeals by researching and compiling medically appropriate documentation.

Referral Coordinator II

Elica Health Centers
Sacramento
05.2021 - 05.2022
  • Coordinated specialty care referrals for patients across multiple disciplines, ensuring timely authorizations and smooth provider communication.
  • Tracked and monitored referral requests, proactively resolving incomplete or inconsistent information.
  • Educated patients on referral processes and follow-up care, improving satisfaction and access to care.
  • Developed collaborative relationships with insurance companies and community specialists to streamline referral workflows.
  • Maintained compliance with HIPAA and clinic protocols under minimal supervision.

Referral Coordinator

Sacramento Native American Health Center
Sacramento
05.2017 - 05.2021
  • Promoted from Call center PSR to front desk and then referral coordinator.
  • Managed high-volume referrals from medical and dental departments, verifying insurance, and submitting authorizations.
  • Coordinated supporting documentation (labs, imaging, x-rays) for specialty services approval.
  • Facilitated communication between providers, specialist, and patients to ensure seamless care coordination.
  • Handled front-desk operations including patient check-in/out, insurance verification, and scheduling follow-ups.

Education

Some College (No Degree) - Business Administration And Management

Heald College
CA

Skills

  • Referral coordination & Prior Authorizations
  • Insurance Verification & Eligibility
  • EHR/EMR Proficiency skilled in EPIC, NextGen, and Athena
  • Patient Access & Advocacy
  • Case Workflow Management
  • Appeals & Documentation Support
  • Provider & Specialist Coordination
  • Bilingual Communication- Fluent in English and Spanish
  • Confidentiality & Compliance
  • Administrative Strengths- Skilled in scheduling, high-volume call management, and cross-department collaboration in fast-paced environments

Timeline

Service Dispatcher

Mark Three Construction
06.2023 - Current

Medical Referral Specialist I

Centene
06.2022 - 01.2023

Referral Coordinator II

Elica Health Centers
05.2021 - 05.2022

Referral Coordinator

Sacramento Native American Health Center
05.2017 - 05.2021

Some College (No Degree) - Business Administration And Management

Heald College

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Viviana Torres