Ana Delmy Escalante Martinez

• Delivers exceptional customer service during every interaction, ensuring positive experiences for all clients, and stakeholders.
• Skilled in conducting comprehensive benefits investigations, including prior authorization processes, and medical versus pharmacy benefit determinations.
• Oversees and resolves all patient access issues, ensuring seamless enrollment and support for individuals within a specialized product program.
• Accurately enters and updates data requirements in designated tracking software to ensure proper documentation and compliance.
• Accurately records and processes all orders and inquiries received via mail, telephone, and in-person patient interactions.
• Accurately records and maintains detailed documentation of all incoming and outgoing communications with patients, caregivers, insurance representatives, and healthcare providers.
• Creates patient activities as a reminder for the following tasks, including, but not limited to, follow-up calls, clinical assessments, referrals to Case Management, discharge initiation, patient letters, mailings, or other reminders related to the patient’s care.
• Regularly engages with colleagues, cross-functional teams, leadership, vendors, and customers to foster collaboration and achieve business objectives.

Patient Care Coordinator:

- Managed high-volume inbound and outbound calls for Humana members.

- Accurately collected and documented medication histories.

- Prepared members for clinical medication reviews.

- Maintained 95%+ satisfaction ratings in member interactions.

• Conducted thorough medication reviews to identify and resolve discrepancies, preventing potential errors.
• Improved medication adherence by delivering personalized patient counseling sessions, adapting communication strategies to individual needs, preferences, and health literacy levels.

• Enhanced inventory accuracy by conducting regular cycle counts and reconciling discrepancies.
• Performed data entry and completed proper paperwork.
• Completed physical inventory counts each month.
• Used vendor knowledge to determine shipping procedures, routes, and rates.
• Utilized inventory management software for tracking and reporting purposes.
• Identified and resolved inventory problems, including damaged or lost items.