Aime Felix Castro
Spring Valley,Ca
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Child and Family Specialist
Rady Children's Hospital Of San Diego
03.2024 - Current
- Encouraged family members to express their emotions and concerns openly during therapy sessions, promoting improved emotional awareness.
- Evaluated the effectiveness of intervention strategies through regular progress reviews, adjusting approaches as needed for optimal outcomes.
- Collaborated with interdisciplinary teams to provide comprehensive support for families in crisis situations.
- Enhanced family dynamics by conducting comprehensive assessments and developing individualized service plans.
- Promoted child well-being by connecting families to essential community resources and support services.
- Built and maintained strong partnerships with community organizations to support the diverse needs of families served, increasing access to vital resources.
- Maintained accurate case records, ensuring efficient documentation for ongoing monitoring and progress evaluation.
- Provided crisis intervention support during emergency situations, helping families regain stability following critical incidents.
Patient Access Representative 3
Rady Children's Hospital Of San Diego
10.2022 - 02.2024
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
- Reduced financial loss through diligent monitoring of outstanding balances and proactive collection efforts with patients and insurers.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
- Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
Authorization Specialist
Imaging Healthcare
07.2018 - 10.2022
- Experience with HMO, PPO, Medicare, Medi-cal, Work Comp
- Insurances
- Submitted authorizations via portals, written, phone call (if needed)
- Followed up with insurances to verify patient benefits, and payments due at time of service
- Helped our Authorizations department while working with IT and upper management complete transfer from Merge Ris to Royal Pay
- Became a super user and key component available for the team if questions occurred.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
Authorization Specialist
Arch Health Medical Group
09.2017 - 07.2018
- Obtained authorizations from various insurances and for different providers
- Responded to inquiries efficiently in regard to current status of authorizations by reviewing the request and evaluating the circumstances to provide the needed information
- Consistently met team metric standards and expectations
- Delegated new updates and information received from providers and healthcare agencies to my team in order to productively adhere to policies, procedures and patient care.
Education
Administrative - Medical Insurance Billing
Brightwood College
Chula Vista, United States07.2015
High School Diploma -
Diego Hills
San Diego, United States06.2013
Skills
- Mental health awareness
- Professional boundaries
- Family advocacy
- Needs Assessment
- Empathy Training
- Role Modeling
- Community Resources
- Case Management
References
Available upon request
Certification
- Victim Assistance Training Online - 41 hours
- Child Abuse & Neglect Mandated Reporter - 4 hours
- CalTrin Intro to Child Trauma Certification
- Cultural Competency Certification
- Domestic Violence essentials Training - 6 hours
Languages
Spanish
Native or Bilingual
Timeline
Child and Family Specialist
Rady Children's Hospital Of San Diego
03.2024 - Current
Patient Access Representative 3
Rady Children's Hospital Of San Diego
10.2022 - 02.2024
Authorization Specialist
Imaging Healthcare
07.2018 - 10.2022
Authorization Specialist
Arch Health Medical Group
09.2017 - 07.2018
Administrative - Medical Insurance Billing
Brightwood College
High School Diploma -
Diego Hills
- Victim Assistance Training Online - 41 hours
- Child Abuse & Neglect Mandated Reporter - 4 hours
- CalTrin Intro to Child Trauma Certification
- Cultural Competency Certification
- Domestic Violence essentials Training - 6 hours
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