Angalina Lopez
Sacramento,CA
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
5
5
years of professional experience
Work History
Patient Service Float-Call Center/Member Service's
Sacramento Native American Health Center
Sacramento
07.2024 - Current
- Received incoming calls from customers and responded to inquiries about product features and benefits.
- Collaborated with other departments to resolve complex issues.
- Conducted regular audits of patient accounts for accuracy of demographic data.
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
- Analyzed complex health plan contracts to determine benefit coverage levels for services rendered.
- Followed up with customers after their interaction with the organization's services.
- Responded promptly to emails from members seeking assistance.
- Assisted with registration for new patients.
- Processed paperwork related to student enrollment and registration.
- Managed registration processes including online forms, ticketing systems.
- Provided excellent customer service throughout the registration process.
- Provided customers contacting call center with exceptional service and support.
- Documented detailed reports of daily activities within the call center environment.
Member Services Interim Supervisor
Sacramento Native American Health Center
Sacramento
04.2024 - 07.2024
- Directs and observes the activities of assigned team, delegates work, documents staff performance issues, and coaches to performance improvement
- Handle and resolve patient escalations with professionalism, compassion and understanding in accordance with company policies and procedures
- Monitors daily tasks or time management of projects to ensure timely completion
- Reviews and submits direct reports’ time sheets
- Serve as a backup to the Member Services Representative position in the event of unexpected absence or at Manager request
- Answer incoming calls for the department and/or see patients in a face-to-face setting as needed
- Familiarity with individual payer guidelines, utilize the Electronic Health Record (EHR) RTS system and/or individual payer websites to obtain eligibility and/or pre-authorization information
- Confirms SNAHC is the assigned Primary Care Physician (PCP) for patient’s insurance plans
- Notifies patients of any eligibility conflicts, outstanding balances and/or out-of-pocket costs associated with visits
- Assist the Billing department in resolving billing problems, as requested by MSM
- Serve as a lead to MSR, include assigning and monitoring work and providing direction to support of the MSM
- Review and audits MSR chart creation: provide daily updates to ensure they are completed correctly, insurances are loaded, and all required documents are scanned and present
- Generate weekly reports including task analysis and submit to MSM for review and performance assessment
- Seek ways to continuously improve customer service, productivity, and process improvement where applicable
- Champion’s SNAHC’s policies and procedures, including compliance with all state and federal laws and regulations, like: HIPAA, Sexual Harassment, Scope of Practice, OSHA etc.
Member Service Representative
Sacramento Native American Health Center
Sacramento
04.2023 - 04.2024
- Answer incoming calls and/or see patients in a face-to-face setting for new patient registration which involves creating demographic charts in the Electronic Health Record (EHR) software for members coming to utilize clinical services as well as eligibility inquiries for established patients
- Provide support to patients regarding Medi-Cal, Medicare and their managed care systems in a clear and professional manner that ensures their understanding
- Utilize the Electronic Health Record (EHR) RTS system and/or individual payer websites to obtain eligibility and/or pre-authorization information for next day appointments
- Confirm SNAHC is the assigned Primary Care Physician (PCP) with patient insurance plans
- Appropriately notifies patients of any eligibility conflicts, outstanding balances and/or out-of-pocket costs associated with visits
- Responsible for ensuring all the information entered into the Electronic Health Record (EHR) is accurate and complete
- This includes reviewing and verifying any paper documents to make sure that all forms are completed, identified, signed and corrected
- Responsible for required data entry as it relates to insurance eligibility prior to any services by any provider, must be able to complete this task efficiently and effectively
- Compliance with all state and federal laws and regulations, as they pertain to position including HIPAA, sexual harassment, Scope of Practice, OSHA, etc.
Patient Access Representative
Sacramento Native American Health Center
Sacramento
07.2022 - 05.2023
- Answered phones promptly in a professional manner.
- Utilized knowledge base to answer inquiries from customers quickly and effectively.
- Answered incoming calls from customers and provided assistance with product inquiries, billing questions, and other customer service related issues.
- Maintained high levels of professionalism while interacting with customers via phone or email.
- Developed effective working relationships with team members across multiple departments.
- Participated in daily huddles with team members in order to discuss common goals and objectives.
- Monitored call queues in order to prioritize incoming calls by urgency or importance level.
- Attended regular training sessions on updates and changes within the industry or organization.
- Performed follow-up calls as necessary to ensure satisfactory resolution of customer inquiries.
- Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance benchmarks.
Customer Service Representative
TDB Communications Group-Medi-Cal
Sacramento
01.2021 - 07.2022
Call Center Customer Service Representative
Employment Development Department (EDD)
Sacramento
07.2020 - 01.2021
- Manage large amounts of inbound call in a timely manner
- Identify customers’ needs
- Identify and escalate issues to supervisor.
Garment sorter
Cintas
Sacramento
08.2019 - 07.2020
- Responsibilities include sorting and organizing uniform shirts and pants numerically in order of sequence on the garment I.D
- Tape to prevent mixed bundles of customer clothes.
Education
High School Diploma -
Antelope View Charter School
Antelope, CA09-2003
Skills
- Insurance Verification
- Scheduling appointments
- Medical terminology knowledge
- Patient Care
- Organizational Skills
- Problem-solving abilities
- Reliability
- Task Prioritization
- Direct Patient Care
- Attention to Detail
- MEDITECH EHR Software
- Decision-Making
- Data Entry
- Recordkeeping
- Organization
- Networking
- Team building
- Computer Skills
Timeline
Patient Service Float-Call Center/Member Service's
Sacramento Native American Health Center
07.2024 - Current
Member Services Interim Supervisor
Sacramento Native American Health Center
04.2024 - 07.2024
Member Service Representative
Sacramento Native American Health Center
04.2023 - 04.2024
Patient Access Representative
Sacramento Native American Health Center
07.2022 - 05.2023
Customer Service Representative
TDB Communications Group-Medi-Cal
01.2021 - 07.2022
Call Center Customer Service Representative
Employment Development Department (EDD)
07.2020 - 01.2021
Garment sorter
Cintas
08.2019 - 07.2020
High School Diploma -
Antelope View Charter School
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