Abigail Rodriguez
Pomona,CA
Summary
Results-driven healthcare operations professional with expertise in care coordination, utilization management, benefits administration, and patient advocacy. Adept at improving workflows, building strong team, provider relationships, and delivering compassionate, high-quality service. Bilingual in English and Spanish, with a proven track record of exceeding performance metrics.
Overview
9
9
years of professional experience
Work History
Integrated Transitional Care Coordinator
Inland Empire Health Plan
Ontario, CA
08.2023 - Current
- - Coordinate safe and timely hospital discharges by serving as liaison between providers, IPAs, and community resources.
- - Expedite delivery of DME and home health services, reducing readmission risks.
- - Train and mentor new team members to ensure process consistency and quality standards.
- - Maintain compliance with all policies and procedures in patient care coordination.
Benefits Advocate
Trustmark
Remote
04.2021 - 08.2023
- - Resolve member inquiries with empathy and accuracy, achieving 95%+ first call resolution rate.
- - Educate members on plan benefits, claims processing, deductibles, and co-insurance.
- - Support digital navigation by guiding members through web portals and Microsoft Teams.
Benefits Customer Service Representative
Prime Healthcare
Ontario, CA
01.2018 - 04.2021
- - Streamlined referral authorization processes for employee health plans, improving turnaround times.
- - Acted as escalation point for complex issues, ensuring timely resolution and member satisfaction.
- -Trained new team members.
Customer Service Registration Rep
LLUH - All's Well Health Care Services
San Bernardino, CA
08.2017 - 12.2017
- - Greeted and registered patients for scheduled outpatient services.
- - Registered Radiology patients for scheduled and walk-in services.
- - Provided timely responses for patients in a busy ancillary procedure department.
- - Performed accurate and detailed data entry, explained forms, and collected liabilities.
- - Collaborated with staff across departments to ensure exemplary patient experiences, reflecting institution's core values.
Program Assistant
LLUH - All's Well Health Care Services
San Bernardino, CA
02.2017 - 06.2017
- - Coordinated logistics for monthly Support Groups, community events, and Patient Advisory Committee meetings.
- - Managed procurement of supplies, equipment, and services for programs.
- - Scheduled monthly meetings, prepared and distributed minutes, and processed check requests/vendor contracts.
- - Drove company vehicle to obtain administrator signatures on legal documents.
- - Reviewed new member applications and followed up on requests for senior and disability programs.
- - Managed member database, produced membership reports, and assisted with community outreach initiatives.
- - Coordinated administrative rounding for leadership, collected and analyzed data, and maintained work improvement plans.
- - Managed department calls, supported Patient Engagement activities, and provided other clerical support as needed.
Education
Certificate of Completion - Adult and Career Education
Chaffey College
Rancho Cucamonga, CACertificate of Completion - Medical Billing & Coding
Pomona Adult School
Pomona, CA01.2017
High School Diploma or GED - undefined
Skills
- Care Coordination
- Utilization Management
- Benefits Administration
- Claims Resolution
- Patient Advocacy
- Microsoft Office Suite
- Epic
- Medical Terminology
- Insurance Verification
- Bilingual (English/Spanish)
LNGG
Bilingual: English/Spanish
Timeline
Integrated Transitional Care Coordinator
Inland Empire Health Plan
08.2023 - Current
Benefits Advocate
Trustmark
04.2021 - 08.2023
Benefits Customer Service Representative
Prime Healthcare
01.2018 - 04.2021
Customer Service Registration Rep
LLUH - All's Well Health Care Services
08.2017 - 12.2017
Program Assistant
LLUH - All's Well Health Care Services
02.2017 - 06.2017
Certificate of Completion - Adult and Career Education
Chaffey College
High School Diploma or GED - undefined
Certificate of Completion - Medical Billing & Coding
Pomona Adult School