ARIEL QUINONEZ
Baldwin Park,CA
Overview
17
17
years of professional experience
Work History
Medical Staff Coordinator
Garfield Medical Center
Monterey Park, CA
01.2024 - Current
- Expedited the onboarding process for new medical staff by efficiently managing initial appointments and reappointments.
- Maintained accurate files, records and credentialing documents in well-maintained databases using MD-Staff.
- Coordinated with various departments to obtain necessary documentation for credentialing processes.
- Received and evaluated applications to look for missing and inaccurate information.
- Guided clinical credentialing and privileging processes to re-appoint medical staff
- Ensured smooth communication flow between departments by acting as a liaison between medical staff services and other administrative units.
- Assisted with special projects as needed, demonstrating adaptability and commitment to the success of the organization.
- Conducted primary source verifications such as board certifications.
Credentialing Specialist
Imperial Health Holdings
05.2022 - 01.2024
- Completes credentialing, re-credentialing, and medical staff applications for clinical staff and submits information to commercial and government payers in a timely manner
- Ensures that all provider files are complete with current licensing and certification documents
- When appropriate, work cooperatively with administrative staff to obtain pertinent information necessary for IPA’S
- Develops thorough understanding of credentialing terminology and documents
- And can utilize external systems used to research and obtain pertinent information
- Responsible for the timely gathering and submitting for processing to IPA’S and health plans on an ongoing basis, all credentialing applications
- Manages provider profiles in practice management
- Tracks all pending applications and notifies the supervisor of any challenges with obtaining information
- Responsible for reviewing and verifying all credentialing documentation for providers, confirming consistency and accuracy based on regulatory requirements
- Notifies employees of expiring licensure and certification documents to ensure100% compliance with credentialing policies
Credentialing Coordinator
Algos Inc – Synovation Medical Group
05.2020 - 05.2022
- Maintained current, accurate, and complete individual provider files
- Collected all medical licenses, CV, drug administration, board certifications, DEA license, and malpractice insurance for physicians and mid-levels
- Process and complete all initial and re-credentialing applications to contracted networks
- Reviewed and completed data entry of credentialing information
- Forward applications to providers and ensured accuracy and completeness of information
- Updated providers CAQH account profiles and format rosters to meet each health plans requirements
Medical Billing/Collector
Algos Inc – Synovation Medical Group
Rancho Cucamonga, CA
04.2017 - 05.2020
- Work claims and claim denials to ensure maximum reimbursement for services provided
- Works directly with insurance companies to get claims processed and paid
- Responsible for processing payments, adjustments and denials according to established guidelines (Payment Posting)
- Successfully works as a team member
- Performs corrections for patient registration information that includes patient demographics and insurance information
- Able to assist with training materials and training staff members
- Works collaboratively with management to create and analyze tracking reports
Authorizations Coordinator
Algos Inc – Synovation Medical Group
Rancho Cucamonga, CA
02.2013 - 04.2017
- Answer authorization status calls and resolving patient authorization issues
- Communicating effectively with insurance carriers/customers via telephone and email
- Filing paperwork and maintaining organization systems
- Data entry and verifying insurance eligibility
- Submit requests for authorizations for HMO’s, PPO’s, and Workers Comp
- Contact HMO’s, PPO’s, and Workers Comp insurances to check authorization status updates, correct procedures and/or facilities
Transcription Assistant /Front Desk
Azusa Pain Management – Synovation Medical Group
Azusa, CA
06.2010 - 02.2013
- Prepared progress report documents through revision and proofreading and delivered via physical mail and email
- Enter medical reports into electronic health records systems
- Identify inconsistencies, errors, and missing information within a report
- Manage the scheduling activities of patients by manually inputting information into Nextgen
- Insurance intake for HMO’s, PPO’s, and Workers Compensation
- Answering high volume inbound calls while addressing patient inquires with accurate and appropriate information in a timely manner
- Date entry of insurance information and authenticating authorized documents for patients
Call Center Representative
Pasadena Rehab Inst. – Synovation Medical Group
Pasadena, CA
06.2008 - 02.2009
- Provided superior customer service for walk-in customers as well as phone inquiries
- Managed the scheduling and confirmation of appointments in an organized manner
- Communicating effective and professionally to insurance carriers via telephone and email
- Accurately recorded patient information and verified insurance eligibility
- Maintained organization by preparing charts and files for client information
Education
Bachelor of Science Degree - Business Administration
Devry University
Pomona, CA01.2025
Skills
- Extensive customer service experience
- Ability to type51 WPM &10 Key by touch150 KPM
- Ability to maintain organization in a fast-paced environment
- Efficient in communicating data to subordinates as well as upper management
- Strong ability to focus attention and perform detailed numeric duties
- Able to lead by example, motivate, recruit & train staff
- Proficient with EMR’s: MD-Staff, Greenway, IMS, Office Alley, EClinical, NextGen, & Medinformatix
- Knowledge of medical terminology, ICD-9and ICD-10/CPT codes
- Proficient in Microsoft Word, Excel, and PowerPoint
Timeline
Medical Staff Coordinator
Garfield Medical Center
01.2024 - Current
Credentialing Specialist
Imperial Health Holdings
05.2022 - 01.2024
Credentialing Coordinator
Algos Inc – Synovation Medical Group
05.2020 - 05.2022
Medical Billing/Collector
Algos Inc – Synovation Medical Group
04.2017 - 05.2020
Authorizations Coordinator
Algos Inc – Synovation Medical Group
02.2013 - 04.2017
Transcription Assistant /Front Desk
Azusa Pain Management – Synovation Medical Group
06.2010 - 02.2013
Call Center Representative
Pasadena Rehab Inst. – Synovation Medical Group
06.2008 - 02.2009
Bachelor of Science Degree - Business Administration
Devry University