Angela Maciel-Castillo

• Remains knowledgeable on product and insurance coverage issues in order to inform patients of copays and other benefit information
• Medical Supply Customer Care Representative for Enteral, Suction, Trach, Incontince, Urological, Ostomy supplies.
• Answers incoming phone calls and faxes, takes customers' orders for durable medical and respiratory equipment and or medications
• Provide and update Customer Service, Resp. Account Exec., Care Coordinator, and Referrals, on ETA's and order status.
• Maintains open communication with patients/clients and referral source Prepares intake, gathers all necessary information about referral, patient demographics, contact person, physician, diagnosis, discharge time and place, item(s) requested
• Gathers all necessary documentation, prior to delivery CMN, Rx, Auth, etc
• Verifies medical necessity with physician
• Verifies eligibility and coverage with Insurance and carrier according to guidelines or contracts
• Verifies payer (with matrix), obtains authorization, expirations
• Informs patient of financial responsibilities: copay, share of cost, deductibles.
• Enters notes in appropriate areas of insurance, general, and authorizations in the computer system
• Process orders for Customer Service Technician to print/fill and or dispatch

· Responsible for accurate submission of data for processing of all HCC claims created by the Coding Team

· Ensure workflow deadlines are achieved timely and accurately

· Meet departmental productivity and accuracy standards

· Ability to handle multiple tasks with extreme attention to detail and ability to follow directions with minimal supervision

· Processes HCC packets per procedure

· Verifies every diagnosis code submitted on an audit packet against the HCC Risk Factor Table to determine if it hits an HCC

· Keys responses accurately into iCode and Access database for tracking and reporting to management

· Batches addendums where there is no EZ-CAP claim and forwards to the Claims Department for processing

· Sorted and processed incoming reports before putting data into processing software.

· Monitors hospital discharges, coordinates retrieval of notes with Health Information Services

· After notes are coded, keys charge into the database

· Process data and correct errors through Business Solutions for Hospitalist billing

· PROGRAMS USED (Q-HMO, ACCESS, ICODE, EXCEL, EZ CAP)

• Created and maintained company phone directory with current extensions and staff information.
• Trained and mentored new PBX operations employees.
• Supported customers by managing 20-100 calls per day efficiently while maintaining professionalism and upbeat tone.
• Maintained up-to-date knowledge of emergency call procedures
• Performed clerical work such as sorting mail, restocking supplies and typing documents.
• Operated digital paging system to notify recipients of incoming calls.
• Scheduled and coordinated conference calls and video teleconferences.
• Received incoming calls and paged individuals and departments over PA system.
• Provided relay service for hearing-impaired users.

• The PR Coordinator will work to implement marketing, education and growth strategies that benefit referring doctors, improve their personal and referral relationships
• Put together and deliver care packages to referring offices
• Ensure referring practices are fully supplied with referral kits
• Email blast marketing, social media, online review monitoring/ strategizing
  Maintain summary of referral relationship status
• Maintained strong knowledge of basic medical terminology to better understand services and procedures.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Assured timely verification of insurance benefits prior to patient procedures or appointments·
• Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
• Achieved insurance pre-authorizations to enable timely patient procedures.
• Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Trained new employees on multiple medical billing programs and data entry software.

• Assisted clinic staff with scheduling, checking patient’s eligibility and maintaining patient’s records
• Will also provide support with other clerical tasks assigned to them
• Assists providers with translation services when necessary
• Establishes and maintains effective communication with patients and department staff
• Acts as customer service Liaison between Medication management and patient-family
• Assists in obtaining laboratory results and schedules patients for appointments in Nextgen
• Sanitized, restocked and organized exam rooms and medical equipment.
• Documented vital signs and health history for patients in clinic and hospital environments.
• Utilized effective communication and active listening skills when interacting with physicians, nursing staff and patients.
• Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions.
• Coordinated with appropriate administrative staff to address clinical, operational and financial questions.
• Called and faxed pharmacies to submit prescriptions and refills.
• Assisted patients with basic care needs.

• Operated cash register for cash, check and credit card transactions with excellent accuracy levels.
• Worked flexible schedule and extra shifts to meet business needs.
• Helped customers complete purchases, locate items and join reward programs.
• Restocked and organized merchandise in front lanes.
• Worked closely with shift manager to solve problems and handle customer concerns.
• Replenished sales floor merchandise and organized shelves, racks and bins for optimal appearance.

• Processed payments effectively and accurately handled cash, credit, debit and personal check transactions.
• Mentored new team members on POS system operation, customer service strategies and sales goals.
• Assisted customers by answering questions and fulfilling requests.
• Educated employees on register use, merchandising and customer service.
• Maintained stock within optimal levels to meet expected customer and sales levels.
• Checked merchandise multiple times during each shift and restocked products when stock ran low.
• Utilized creativity and persuasive techniques to upsell and cross-sell products to customers.

• Operated cash register for cash, check and credit card transactions with excellent accuracy levels.
• Worked flexible schedule and extra shifts to meet business needs.
• Helped customers complete purchases, locate items and join reward programs.
• Restocked and organized merchandise in front lanes.
• Promoted customer loyalty and consistent sales by delivering friendly service and knowledgeable assistance.
• Worked closely with shift manager to solve problems and handle customer concerns.
• Maintained secure cash drawers, promptly resolving discrepancies in daily totals.
• Replenished sales floor merchandise and organized shelves, racks and bins for optimal appearance.
• Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies.