Angelica Agosto Medero
Tampa,FL
Summary
Dynamic Human Services Program Specialist with extensive experience at the FL Department of Health, excelling in data gathering and analytical problem-solving. Proven track record in enhancing client well-being through tailored interventions and effective case management. Bilingual in English and Spanish, fostering cultural awareness and collaborative team engagement to improve service delivery.
Overview
15
15
years of professional experience
1
1
Certification
Work History
HUMAN SERVICES PROGRAM SPECIALIST- Case Manager
FL Dpt of Health/Disease Control/Refugee Clinic
10.2024 - Current
- Assists refugees in need of follow-up medical care for medical conditions, including helping schedule their health assessment appointment.
- Provided thorough documentation of client interactions, enabling accurate tracking of progress and informed decision making.
- Serves as a health care resource by working with refugee resettlement agencies’ staff during the first three months of resettlement from the time of their health assessment visit to ensure that refugees receive information about how the healthcare system works.
- Managed caseloads effectively, prioritizing urgent cases while maintaining high-quality service for all clients.
- Educates on how to navigate the healthcare system, the appropriate use of various healthcare facilities, and accessing public transportation for the purposes of attending medical care appointments. Initiates new case management services and works in close collaboration with health department staff, refugee resettlement agencies, and other refugee service providers to facilitate client’s referrals to ensure refugees receive the maximum benefit from services available to them.
- Created tailored intervention strategies for clients, resulting in improved overall well-being and selfsufficiency.
- Organized workshops and training sessions for staff, promoting continuous professional development within the team.
- Provided crisis intervention services as needed, demonstrating quick decision-making and problem-solving abilities under pressure.
- Assists refugees in need of follow-up medical care for medical conditions, including helping schedule their health assessment appointment.
- Uses telephonic interpretation services; assist in referring refugees and identifying the appropriate medical care providers for the client’s medical need(s); Schedules medical care appointments for high-risk clients and follows up with the physician office to assure medical care was received as necessary.
- Assists with navigating the healthcare system and mentors the refugee until they are ready to access healthcare independently.
- . Works with the local refugee resettlement agencies to obtain current listings of physicians in the community and expands the list as additional service providers are identified.
- Participates in local Refugee Resettlement and Refugee Task Force meetings
Insurance Specialist III
FL Dept of Financial Services/Workers Compensation
09.2021 - 10.2024
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Provides education on workers’ compensation law, rules, procedures, managed care arrangements, safety, rehabilitation programs, rights, responsibilities, obligations and other information pertinent to the request for assistance to carriers in an effort to resolve issues and documents the results.
- Maintained high standards of customer service by building relationships with clients.
- Responsible for dispute prevention and resolution through early involvement in the claims process, dissemination of information and education; investigation of disputed issues, outreach efforts and facilitation of the request for assistance process performed independently and is subject to periodic review by the Supervisor.
- Makes immediate contact with injured employees by phone and/or letter after receipt of a notice of injury.
- Provides explanation of rights and responsibilities under workers’ compensation law and documents intervention contacts in database.
- Identifies disputed issues, conducts investigations, contacts appropriate parties and attempts to facilitate resolution of disputed issues, documents investigation outcomes in database, and provides written notification of outcome to necessary parties, when appropriate.
- Provides toll free assistance number to injured employee for future reference.
- Provides education and information to the general public or injured employees who contact the bureau by way of telephone, written correspondence, or walk-in visits to field or central offices.
- Identify, assist and provide appropriate referral for individuals deemed to be in crisis situations.
- Initiates contact with workers’ compensation carriers to facilitate resolution of injured workers’ requests for assistance.
- Promotes the early intervention process, provides public education and information on workers’ compensation law, rules, regulations, etc., through outreach contacts.
- Conducts investigation of special assignments, contacts appropriate parties and attempts to facilitate resolution of disputed issues, documents investigation outcomes in database, and provides written notification of outcome to necessary parties, when appropriate.
Public Assistance Specialist
FL Dept of Health/Disease Control/TB Clinic
08.2016 - 09.2021
- Managed caseloads efficiently while maintaining high levels of accuracy in benefit calculations and case documentation.
- Maintains proficiency with procedure and diagnosis coding (ICD-10 and CPT coding), coordinating with providers for accuracy on super-bill and billing updates.
- Coordinated with healthcare providers to ensure seamless access to medical services for clients receiving benefits from various programs and health insurance company.
- Responsible to collect medical service payment at the end of the visit. Processes refunds or waivers as required
- Analyzed program data to identify trends and areas for improvement, informing policy adjustments and resource allocation decisions.
- Provided empathetic support to clients during their time of need, fostering strong relationships built on trust and understanding.
- Follows up with Insurance companies and primary doctors to ensure insurance company payments and authorizations.
- Meeting with Supervisor and Manager providing briefs on the current fiscal status of the clinic; identifying problems and proposing solutions.
- Generates and submits required reports in a timely manner to include the Cash Drawer Day Sheet and Daily Posting Reports.
- Maintains proficiency with procedures and diagnosis codes, coordinating with providers to correct errors. Processes billing for clients under Memorandum of Agreement.
- Coordinates research of new/rare products and obtaining quotes for all items (minus office supplies)
- Assist in maintaining an adequate inventory of office forms, equipment and supplies.
- Responsible for related purchases and arranging for timely repairs as needed.
- Translates from Spanish to English and English to Spanish to the clinical staff or sometimes goes out in the field with the clinician staff to translate.
- Provide support to the front desk when necessary, by registering clients, completing necessary forms, ensuring accurate and up-to-date: demographic, insurance and financial (income verification via WAGES/AWI) data is entered into HMS.
- Provide support to the Medical Record area when necessary, maintaining, organizing, inspecting and filing medical records and documents.
- Attends approved training sessions. Travels and performs other related duties.
Senior Clerk
FL Department of Health / Nutrition/ WIC Office
11.2013 - 08.2016
- Prioritized workload effectively managing multiple tasks at once maintaining focus under pressure while meeting deadlines consistently.
- Provide services to clients who are participants in the supplemental Nutrition Program for Women Infants and children.
- Interview clients to obtain client demographic and income information. Input and update client information into the Florida Wise data base System
- Conduct interviews to determinate eligibility for clients by collecting and updating personal date on applicants. Clients and household member at certification and recertification.
- Set up meetings and organized supporting materials.
- Refer cases of suspected fraud to appropriate mangers for investigations.
- Assess medical eligibility status in Medicare (FMMIS) database and assess immunization status using Florida Shots record database.
- Access completion of medical food prescriptions for diagnosis, metabolic formula amounts, frequency and medical authorization.
- Issue WIC EBT benefits and formulas form inventory.
- Attend meetings, workshop and in-service trainings related to job duties and /or Department.
Authorization Agent /Virtual Assistant/Remote
Quantum Results
08.2010 - 10.2013
- Monitored emails, organized inbox, prioritized messages for: Colon Rectal Clinic Office Bariatric Surgeon | Clinic Office Endocrinologist Surgeon Office | Digestive and Hepatobiliary | Call Center.
- Answered and screened calls to provide information, schedule appointments and take detailed messages.
- Facilitated smooth operations with proficient data entry and document management for various projects.
- Maintained a well-organized database system for improved information accessibility in daily operations.
- Review and request eligibility of benefit in each medical order directly received by the medical office by fax or e-mail. •Send via e-mail or Fax the order requesting medical pre authorization of each surgical procedure.
- •Work with codes (Cpt – Icd9) and rates of surgical procedures.
- Advise patient in advance if procedures have any copayments.
- Do calls constantly to medical plans, follow up of pre authorization pending cases.
Education
Associate of Science - Medical Assistance|CMA
Sanford Brown College
Jacksonville, FL11-2015
High School Diploma -
Superior Cacique Agueybana
Puerto Rico 05-1997
Skills
- Data Gathering
- Cultural Awareness
- Training Delivery
- Policy Evaluation
- Analytical Problem-Solving
- Collaborative Team Engagement
- Fluent in English and Spanish
- Consistent Honesty in Professional Conduct
- Dependable and Responsible
Certification
- First Aid Certification
- Florida Driver's License
- Certified Medical Assistant (CMA)
- Mental Health First Aid (Adult)
- Florida Insurance Claims Adjuster License- 620
Languages
Spanish
Full Professional
English
Full Professional
Timeline
HUMAN SERVICES PROGRAM SPECIALIST- Case Manager
FL Dpt of Health/Disease Control/Refugee Clinic
10.2024 - Current
Insurance Specialist III
FL Dept of Financial Services/Workers Compensation
09.2021 - 10.2024
Public Assistance Specialist
FL Dept of Health/Disease Control/TB Clinic
08.2016 - 09.2021
Senior Clerk
FL Department of Health / Nutrition/ WIC Office
11.2013 - 08.2016
Authorization Agent /Virtual Assistant/Remote
Quantum Results
08.2010 - 10.2013
Associate of Science - Medical Assistance|CMA
Sanford Brown College
High School Diploma -
Superior Cacique Agueybana
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