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
CASkills
- 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