Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Araceli Bustamante

Victorville,CA

Summary

Resourceful Program Specialist offering expertise in problem-solving, data analysis and customer service. Adept at quickly learning new technologies and processes for driving success. Proven track record of successfully managing multiple projects and developing innovative solutions.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Quality Improvement Specialist

Choice Medical Group
04.2022 - Current
  • Maintained current clinical knowledge by participating in monthly Health Plan meetings and trainings to provide monthly Provider and office staff trainings.
  • Developed quality improvement plans, policies and operational guidelines.
  • Documented and reported issues with compliance, standards of care and quality assurance requirements.
  • Reported billing discrepancies to management and educate providers and office staff to improve quality scores for incentives.
  • Submit claims and patient reported data to various health plans on behalf of providers
  • Gather weekly and Monthly reports from various computer systems to present data to Providers and staff.
  • Manage multiple priorities while meeting deadlines.

Order Coordinator

McElroy Metal
10.2021 - 04.2022
  • Assist manager in scheduling orders, handle rush requests from sales reps or customer service reps
  • Release orders into production
  • Handle void/customer changes after order placed
  • Create X.O entry for customer refunds, replace damaged or lost orders
  • Communicate with fellow employees and departments regarding any discrepancies with customers orders
  • Balanced back order spreadsheets, open/close status of orders
  • Notify customers via phone or email regarding order changes and/or updates
  • Collaborated in timely processing of billing and accounts receivables.
  • Prepared detailed documents and reports in adherence administrative processes for month end.
  • Assist in some Payroll duties when HR was behind
  • Assist HR in interview process or any areas admin needed help

Patient Services Representative

TriWest Healthcare Alliance
01.2019 - 04.2020
  • Provide customer service related to Veteran care through community care network in a fast-paced call center.
  • Respond to inbound calls and chat messages regarding authorizations for medical and behavioral health care
  • Assist providers, veterans or Veteran's Affairs with claims payment and status
  • Accurately assess caller requests while focusing on first call resolution and/or appropriate call escalation protocols.
  • Schedule outbound calls to schedule veteran appointments based on veteran or VA request.
  • Resolve administrative eligibility discrepancies through EMR accounts for research and review.


Team Lead

Wetzel's Pretzels
06.2014 - 01.2019
  • Managed schedules, accepted time off requests and found coverage for Call Out/No Shows
  • Worked different stations to provide optimal coverage and meet production goals.
  • Handled troubleshooting tasks and used repair methods to immediately rectify assembly line issues.
  • Directed and supervised team of 12 engaged in proper training and development.
  • Tracked receipts, employee hours and inventory movements.
  • Interpreted and enforced operating instructions, procedures and safety rules.

Education

High School diploma - undefined

Silverado High School
Victorville, CA
2011

Skills

  • Bilingual
  • AP/AR
  • Insurance Verification
  • HIPAA
  • Microsoft Excel
  • Microsoft Outlook
  • Microsoft Word
  • Payroll
  • Data entry
  • EHR/EMR systems
  • Administrative
  • Department Oversight
  • Sales Tracking
  • Business Leadership
  • Customer Order Tracking
  • Vendor Relationships
  • Time Management
  • Data Abstraction
  • Daily Logs
  • Recording Data
  • Special Projects
  • Software Applications

Certification

Medical Terminology

Timeline

Quality Improvement Specialist

Choice Medical Group
04.2022 - Current

Order Coordinator

McElroy Metal
10.2021 - 04.2022

Patient Services Representative

TriWest Healthcare Alliance
01.2019 - 04.2020

Team Lead

Wetzel's Pretzels
06.2014 - 01.2019

High School diploma - undefined

Silverado High School

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