ASTRID CAMACHO
Garden Grove,CA
Summary
Experienced and competitive workforce solutions operations planner with a strong focus on strategic planning. Skilled in providing excellent customer service and experienced in care plan and sales force. Fluent in both English and Spanish with proficiency in verbal, reading, and writing skills. Typing speed of 50+ WPM and expertise in EHR Implementation, specifically with Razor edge software, QuickBooks, teams, and Jabber. Over 200 hours of experience as a pre-licensed behavioral therapist, successfully securing and servicing contracts for network expansion. Extensive knowledge of managed care and integrated delivery networks, with excellent compliance training and principles of responsibility. Well-versed in medical terminology and knowledgeable about Medicare and Medi-Cal guidelines and regulations. Proficient in Microsoft Office Professional (Excel, Word, PowerPoint, Outlook) with the ability to work independently or as part of a team. Received CCS claim adjudication and quality assurance training. Proven track record in managing credentialing operations and ensuring compliance. Valued for strong collaborative skills and ability to achieve results through efficient processes. Known for adaptability and reliability in dynamic environments, with expertise in documentation and regulatory standards.
Overview
14
14
years of professional experience
Work History
CREDENTIALING SPECIALIST
AYA HEALTHCARE
03.2020 - 02.2024
- Build trusting relationships with internal and external parties
- Demonstrated excellent problem-solving skills when confronted with complex issues or discrepancies during the credentialing process.
- Improved turnaround time for credentialing applications by implementing an efficient online system.
- Conducted primary source verifications such as background checks and board certifications.
- Assisted in training new employees on proper credentialing procedures, contributing to their rapid integration into the team environment.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Developed and implemented onboarding and orientation programs for new employees.
- Gain independence in the CS role by becoming familiar with available resources and having the ability to discern which to use in varying situations and scenarios
- Build knowledge around Key Performance Indicators (KPIs) and other drivers of success in the role
- Demonstrate ability to maintain workload while meeting KPIs and meet established departmental SLAs
- Prioritize daily tasks to show effective time management, allowing the ability to assist with overflow candidates/additional projects as needed
- Maintain a strong sense of urgency with candidates to ensure established deadlines and start dates are met
- Demonstrate ability to effectively manage individual workload and the workload of another CS, when coverage is needed
- Work independently and as part of a team
- Provided exceptional customer service to both internal and external stakeholders, addressing inquiries promptly and professionally.
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Expedited the onboarding process for new providers, ensuring timely completion of all required documentation and verifications.
PROGRAM COORDINATOR
USC KECK MEDICAL-AXELON
07.2020 - 09.2020
- Support all aspects of the planning processes and program development for assigned meetings, including scheduling, and running select conference calls in the development of educational and scientific content, follow-up correspondence, and online data entry
- Assist with special projects as needed, under the umbrella of digital meeting transformation and future new Education Department initiatives
- Proven ability to work independently, exercise good judgement, identify problems, interpret policy, and recommend solutions
- Ability to maintain strict confidentiality and handle sensitive matters discreetly
- Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
- Established strategic partnerships with external organizations, expanding program reach and impact.
- Provided exceptional customer service to program participants through prompt response times and attentive assistance with inquiries or concerns.
UNDERWRITER COORDINATOR
UHC-ADECCO
07.2020 - 08.2020
- Ability to prioritize and complete a high number of tasks while maintaining the established 24-hour turnaround time
- Communicate clearly with both internal and external clients, both on the phone and via email
- Assist with organizing team meetings via teams as we all are teleworking
- Update and maintain desktop level procedures
- Supporting the underwriting team by inputting information and documents into our management system
- Creating relationships both internal and external to the organization
- Provided excellent customer service by addressing inquiries promptly and offering comprehensive explanations of underwriting decisions.
- Documented underwriting decisions and provided evidence of compliance with applicable regulations.
- Determined and documented loan conditions and communicated requirements and decisions.
Training Program Coordinator
CalOptima
07.2020 - 02.2020
- Planning retention events and assigning projects to point of contact for provider relations, pharmacy, business integrations, behavioral health, and outside vendors
- Administrative support and record management training with sales representatives
- Managing technical projects and conduct weekly enrollment source reports
- Review all assessments from members with overdue referrals for completeness
- Scheduling meetings and monthly audits with sales representatives
- I develop and effectively deliver a training program for the OneCare Sales team
- Plan retention events with a goal of growing our member count in the One Care and One Care Connect program and I report CMS Monthly events to RAC
- I ensure that sales and marketing staff operate within the guidelines and regulations governing an educational institution
- Handle inbound and outbound calls for prospective members, provider network changes, plan changes, and CMS point of contact
- Consistently supported compliance and code of conduct protecting the assets of the organization
- Attention to detail, accuracy, and quality
- Utilize internal business systems for maintaining and creating requested reporting from that database
- Conduct weekly audits on Spanish and English enrollments and teach Extensive sales training and techniques
- Maintained accurate records of program participation, completion rates, and evaluations to inform future improvements in content and delivery methods.
- Enhanced participant engagement by incorporating interactive activities and multimedia resources into training programs.
- Coordinated logistics for training events, including scheduling facilities, securing necessary equipment, and managing participant registration.
- Collaborated with department managers to design customized training plans aligned with organizational goals.
- Provided coaching and mentoring to employees.
- Delivered high-quality classroom instruction using a variety of teaching methods tailored to individual learning styles.
LEAD PROGRAM COORDINATOR TALENT ACQUISITION
VOLT CORP
10.2018 - 07.2019
- Submitting the ideal candidates for our clients and their business needs
- Liaison between HR recruiters and Client Managers
- Coordinated online training for new candidates
- Conduct monthly meetings and trainings for my team
- Site visits at RICOH, Healthcare Partners, Apple, Home Depot
- Records management and conduct weekly webinar meetings with clients
- Create and develop marketing materials, training staff in medical terminology, medical record navigation
- Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
- Established strategic partnerships with external organizations, expanding program reach and impact.
- Provided exceptional customer service to program participants through prompt response times and attentive assistance with inquiries or concerns.
- Monitored performance metrics closely to evaluate areas requiring intervention or adjustment, making data-informed decisions that contributed positively towards overall results.
PROGRAM COORDINATOR
SCAN HEALTH PLAN
08.2018 - 11.2018
- Provide short term care coordination for my share of members I am assigned
- Educate and guide new members with care coordination needs
- Navigate internal business system to manage referrals for community-based resources
- Counsel clients to take an active role in their care, utilizing self-management support and patient education with my managers supervision
- Adhere to all quality, compliance, and regulatory standards to achieve IAH and SCAN outcomes
- Community outreach
- Provide education about resources and documents the information on a timely basis
- Receive referrals via intake staff and conducts client assessment to determine service needs
- Assist in team building activities every month
- Maintained detailed records of program activities and participant data, ensuring compliance with internal policies and external regulations.
PATIENT CARE COORDINATOR
WESTERN DENTAL & ORTHODONTICS
02.2018 - 06.2018
- Discuss cost of service, insurance coverage and payment options with patients
- Coordinating providers' schedules and ensuring the smooth and efficient flow of patient care
- Balancing daily and monthly accounts and reporting data to corporate
- Scheduling post-op appointments, records management
- Assist in documenting treatment plan for patients
- Interpreting treatment plan from doctor to patient
- Verified patient insurance eligibility and entered patient information into system.
- Delivered excellent patient experiences and direct care.
- Resolved customer complaints using established follow-up procedures.
- Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Assisted in the development of care plans tailored to individual patient needs, improving overall health outcomes.
- Provided compassionate support for families during difficult healthcare decisions, acting as a liaison between them and their loved ones'' medical team.
Event Coordinator
ALSAC ST. JUDE C.R.H
11.2017 - 02.2018
- Modifying Enterprise Contact Center applications and executing ADHOC requests under moderate supervision
- Collaborate with all departments to determine and improve metrics reported
- Collaborates with system users and technical resources
- Responsible for compiling, summarizing, analyzing, and reporting information for developing and modifying Enterprise Contact Center applications
- Collaborates with system users and technical resources
- Assist marketing department with fundraiser events
- Create excel spreadsheets tracking new patrons
- Coordinated schedules and timelines for events.
- Brainstormed and implemented creative event concepts and themes.
ABA BEHAVIORAL THERAPIST
NYANSA LEARNING CORPORATION
10.2017 - 01.2018
- I provide clinical skilled instructions and behavior reduction protocols
- Behavior analysis to children with autism and related developmental disabilities in the home, community, and school settings
- I ensure students operate within the guidelines and regulations governing an educational institution and study patient behavior and apply ABA principles
- Weekly audits done by supervisors to ensure my teaching techniques are up to par
- Teach families about my behavioral redirection techniques
- Records management and conduct meetings
- Assist families by interpreting from English to Spanish direction from supervisors
- Responded effectively to crisis situations and aggressive behaviors, skillfully mitigating conflicts with proven strategies.
- Empowered clients through the acquisition of adaptive living skills such as money management, meal planning, household chores, and personal hygiene tasks.
- Trained parents and caregivers in behavior management strategies, empowering them to support their child''s growth at home effectively.
PROGRAM COORDINATOR
SCAN HEALTH PLAN
08.2017 - 01.2018
- Provide short term care coordination for my share of members I am assigned
- Educate and guide new members with care coordination needs
- Navigate internal business system to manage referrals for community-based resources
- Counsel clients to take an active role in their care
- Review all assessments from members with overdue referrals for completeness
- Utilizing self-management support and patient education with my managers supervision
- Adhere to all quality, compliance, and regulatory standards to achieve IAH and SCAN outcomes
- Provide education about resources and documents the information on a timely basis
- Receive referrals via intake staff and conducts client assessment to determine service needs
CASE COORDINATOR
CCS CALWORKS
07.2015 - 01.2017
- Comply with all child and dependent adult/elder abuse reporting laws and policies and confidentiality agreements
- Participate in development of family plans
- Communicate regularly with CA-Based Project Manager to ensure data collection is executed with fidelity, internal site implementation is running smoothly, and to trouble-shoot any problems or challenges
- Assist families in contacting and utilizing community resources
- Comply with all YPR reporting procedures, most notably ADP time-tracking and expense reporting
- Attend training session with YPR National Program Director to become familiar with the EPIC program, develop communication and small group leadership skills, and establish best practices for peer support
- Maintained current knowledge of applicable procedures and compliance requirements to optimize effectiveness.
- Collaborated closely with external agencies to ensure seamless service provision, minimizing gaps in care for clients.
- Participated in ongoing professional development opportunities to stay current on best practices in case management and enhance skills as a Case Coordinator.
- Acted as an advocate for clients when necessary, ensuring their needs were met and their voices heard throughout the case management process.
ACTIVITIES COORDINATOR
THE GROVES OF TUSTIN SENIOR LIVING
02.2013 - 11.2015
- Monthly trainings in educational programs with leadership team
- Quarterly progress notes and assessments
- Co-develop a planned schedule of social and other enriching individual or group activities
- Development of monthly activity calendar
- Creation and documentation of Person-Centered individual plans of care/activity plans developed for activity services
- Assist with decorating facility, shopping for seasonal and Center events
- Build relationships with residents and their families
- Meet Person Centered needs and interests of each participant and provides opportunities for involvement, both individual and group, in the planning and implementation of the activity program
- Coordinate birthday parties, holiday celebrations in our courtyard
- Coordinated, planned, developed and implemented activities designed to enrich lives of assisted living residents.
- Sought and obtained community opportunities for cultural and recreational participation and safely transported residents to and from locations.
- Ensured safety and compliance with local regulations by conducting regular audits of program spaces, equipment, and materials.
VACATION PLANNER
DISNEYLAND RESORT
01.2010 - 02.2013
- Booking vacation packages telephonically for guests from all over the world
- Upselling signature suites to meet quota
- Follow a script word for word when booking packages
- Problem solves any issues with existing bookings
- Provide outstanding customer service
- Utilize internal business system to check availability at Disneyland Hotels
- Utilized advanced knowledge of reservation systems to secure best possible rates for flights, hotels, and car rentals.
- Provided exemplary customer service to new and existing clients, which helped build lasting relationships and secure new travel assignments.
- Promoted dedicated customer service and support by promptly resolving customer complaints.
Education
High School Diploma -
GARDEN GROVE HIGH SCHOOL
Garden Grove, CA06-2010
Skills
- Competitive and strategic planner
- Workforce solutions operations
- Great customer service skills
- Care plan and sales force experience
- Fluent in English and Spanish (verbal, reading, writing)
- Accurate typing 50 WPM
- EHR Implementation specialist
- Razor edge software, QuickBooks, Teams, Jabber
- More than two hundred hours working as a pre-licensed behavioral therapist
- Secured and serviced contracts with large health care systems, behavioral health clinics and individual provider offices for network expansion
- Knowledge of managed care and integrated delivery networks
- Excellent compliance training and principles of responsibility
- Extensive sales training and techniques and school compliance experience
- Knowledge of medical terminology, Medicare, Medi-Cal guidelines and regulations specific to health care field
- Proficient in Microsoft Office Professional (Excel, Word, PowerPoint, Outlook)
- Demonstrated ability to work independently and as a team
- CCS claim adjudication and quality assurance training
- HIPAA compliance
- Provider enrollment
- Background checks
- Data management
- Provider relations
- Application management
- Regulatory compliance
- Employee onboarding
- Management collaboration
- Credential verification
References
Available upon request
Languages
Spanish
Native or Bilingual
Timeline
PROGRAM COORDINATOR
USC KECK MEDICAL-AXELON
07.2020 - 09.2020
UNDERWRITER COORDINATOR
UHC-ADECCO
07.2020 - 08.2020
Training Program Coordinator
CalOptima
07.2020 - 02.2020
CREDENTIALING SPECIALIST
AYA HEALTHCARE
03.2020 - 02.2024
LEAD PROGRAM COORDINATOR TALENT ACQUISITION
VOLT CORP
10.2018 - 07.2019
PROGRAM COORDINATOR
SCAN HEALTH PLAN
08.2018 - 11.2018
PATIENT CARE COORDINATOR
WESTERN DENTAL & ORTHODONTICS
02.2018 - 06.2018
Event Coordinator
ALSAC ST. JUDE C.R.H
11.2017 - 02.2018
ABA BEHAVIORAL THERAPIST
NYANSA LEARNING CORPORATION
10.2017 - 01.2018
PROGRAM COORDINATOR
SCAN HEALTH PLAN
08.2017 - 01.2018
CASE COORDINATOR
CCS CALWORKS
07.2015 - 01.2017
ACTIVITIES COORDINATOR
THE GROVES OF TUSTIN SENIOR LIVING
02.2013 - 11.2015
VACATION PLANNER
DISNEYLAND RESORT
01.2010 - 02.2013
High School Diploma -
GARDEN GROVE HIGH SCHOOL
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