ALMA ESCAMILLA
Buena Park,CA
Summary
Results-driven Operations Manager with expertise in healthcare processes and client relations. Streamlined documentation to enhance service delivery and improve operational efficiency. Led cross-functional teams in case management, implementing quality control measures that reduced errors and increased compliance. Analyzed performance metrics to drive continuous improvement and elevate client satisfaction.
Overview
18
18
years of professional experience
Work History
Operations Manager
Elevate PFS
orange, CA
2024.03 - Current
- Coordinated with hospital leadership and staff to streamline documentation collection for case management via reports.
- Performed periodic audits of case files to ensure accuracy and completeness.
- Provided technical guidance to intake advocates on program requirements and procedures related to enrollment processes.
- Developed partnerships with hospital UM teams, revenue cycle managers, and financial counselors to enhance patient and family support in obtaining health care coverage.
- Collaborated with hospital teams to optimize patient documentation of referrals and work queue review.
- Compiled and analyzed reports on key metrics for intake team, including in-house accounts, overdue accounts, and productivity trends.
- Achieved bonus in LA and OC regions for three consecutive quarters.
- Oversaw 22 facilities across LA and OC regions, including PIH, Kaiser Permanente, Hoag, and KPC facilities.
Eligibility Supervisor
Elevate PFS
orange, ca
2022.10 - 2024.03
- Implemented quality control measures that enhanced accuracy of eligibility decisions, reducing errors.
- Trained and guided staff on eligibility assessment procedures and compliance standards.
- Supervised a team of 8+ advocates in navigating epic/ms4 and hospital systems.
- Evaluated case files for accurate documentation and regulatory adherence.
- Coordinated interdepartmental communication to ensure timely dissemination of eligibility updates and changes.
- Developed training materials for new hires on eligibility guidelines and procedures.
- Monitored staff performance to ensure uniform application of criteria, fostering compliance across teams.
- Conducted performance evaluations to assess the progress and skills of staff members.
Bilingual Staff Advocate
Bilingual Staff Advocate
Anaheim, USA
2020.02 - 2022.10
- Managed case workflow, ensuring completion of screening processes and application submissions.
- Coordinated COB and FS case processing for timely and accurate submissions across DDSD, Magi, Non-Magi, and government-issued applications.
- Maintaining clear, consistent update notes and obtaining determination, if needed completing appeal process.
- Currently handling over 170 cases.
- Maintaining over 100 approvals as well as meeting KPI and updating case to meet expectations daily as well as weekly.
- Organized daily cases to maintain manageable workload and keep overdue items under 50.
- Assisting overdue accounts for additional Departments; in-house Team, Kaiser Team, Mpower-A, Guerra Team.
- Evaluated case files to ensure accurate documentation and adherence to regulations.
- Trained and guided staff in eligibility assessment procedures and compliance standards.
- Assisted with staff development and training.
External Care Coordinator
Comfort Keepers
Arcadia, USA
2018.02 - 2020.02
- Currently overseeing caregivers and clients.
- Coordinated client management, ensuring quality services, staff development, recruitment, and care plan implementation.
- Manage weekly schedules for clients and their caregivers.
- Navigated unique and complex situations for clients and their families, fostering effective communication and support.
- Responded promptly to schedule changes, hospital discharges, and quality of care updates, enhancing service delivery.
- Provided top-level customer service by addressing client inquiries and resolving issues promptly.
- Utilized Microsoft Office, Excel, and ADP software to streamline administrative tasks and manage data effectively.
- Comfort Keepers provides in-home care services to seniors and other adults.
Senior Store Manager
Money Mart
USA, USA
2013.04 - 2018.02
- Directed and supervised employees in sales and customer relations to meet store budget and increase overall revenue.
- Supervised team of 3 to 6 members to ensure operational efficiency.
- Addressed staff communication issues and improved store organization while identifying internal or external fraud.
- Completed monthly schedules according to payroll policies.
- Maintained daily, weekly and monthly records and audits to ensure within company regulations.
- Processed various financial transactions including CTRs, ACH, wire transfers, loans, withdrawals, and deposits.
Assistant Manager
El Pollo Loco
Anaheim, USA
2009.01 - 2013.04
- Managed 15 to 20 employees per location.
- Monitored the daily activities of 6-8 employees per shift.
- Maintained high level for customer service standards as well as food quality.
- Assisted with recruitment and hiring processes.
- Focused on daily inventory count and quality audits.
- Maintained cash handling responsibility while submitting cash orders or deposits.
Education
High School Diploma - Garden Grove, CA
Hare High School
Garden Grove, CA2005-01
Skills
- Revenue cycle management
- Case and claims management
- Healthcare operations
- Process improvement
- Operations monitoring
- P&L management
- Performance reporting
- Client relationship management
- Customer service and support
- Documentation management
- Microsoft Excel and Office Suite
- Cross-functional leadership
- Leadership development
- Staff training and development
- Employee motivation strategies
- Conflict resolution and employee relations
- Risk management
- Project planning and execution
- Business development strategies
- Financial operations oversight
- Account analysis and banking expertise
- Attention to detail in processes
- Effective communication skills
- Time management techniques
- Security process implementation
- Organizational skills enhancement
- Internal and external stakeholder relations
Willing To Relocate
Orange County, CA, Long Beach
Personal Information
- Active TACA volunteer, participating in community health fairs and outreach events.
- Receive ongoing training and support in advocating for individuals and families within the autism community
Timeline
Operations Manager
Elevate PFS
2024.03 - Current
Eligibility Supervisor
Elevate PFS
2022.10 - 2024.03
Bilingual Staff Advocate
Bilingual Staff Advocate
2020.02 - 2022.10
External Care Coordinator
Comfort Keepers
2018.02 - 2020.02
Senior Store Manager
Money Mart
2013.04 - 2018.02
Assistant Manager
El Pollo Loco
2009.01 - 2013.04
High School Diploma - Garden Grove, CA
Hare High School