Barbara Tauler
Hialeah
Summary
Detail-oriented and patient-focused Certified Medical Assistant with over 10 years of comprehensive experience in delivering a wide range of healthcare services and administrative support to achieve organizational goals. Passionate about providing exceptional, compassionate patient care and serving diverse populations within the healthcare industry. Highly organized and able to manage multiple tasks efficiently in fast-paced, high-pressure environments.
Overview
14
14
years of professional experience
Work History
Utilization Management Coordinator
Claremedica Health Partner
01.2024 - Current
- Conduct comprehensive assessments of the medical needs and challenges of high-utilization patients
- Collaborate with patients, healthcare providers, and support services to develop personalized care plans
- Serve as the primary point of contact for high-utilization patients, addressing their medical concerns and questions
- Communicate with hospitals, attending physicians, PCPs, and Insurance Carriers' Nurse Reviewers to track daily admissions and discharges
- Coordinate medical care follow-up for patients discharged from inpatient facilities
- Facilitate direct placement in nursing homes, as needed
- Assist PCPs in placing patients in skilled nursing facilities
- Coordinate all aspects of patient care, including appointments, tests, treatments, and follow-up care
- Facilitate referrals to specialists or other healthcare facilities as needed for continuity of care
- Advocate for the patient's needs and preferences to ensure a smooth medical journey
- Identify and access community resources, social services, and support programs to assist utilizers patients
Medicare Care Coordinator
Mount Sinai Medical Center
01.2021 - 01.2023
- Record patient’s vital signs and symptoms such as their blood pressure
- Interviewing patients and recording their medical history
- Help physicians call the pharmacy for medication refills
- Go over the administering medication with patients
- Schedule appointments for patients either with PCP or any specialist
- Verify demographics and insurance
- Update electronic health records
- Assist patients by acting as an advocate
- Assists in coordinating care for patients identified at risk, and chronic care management
- Maintains a daily log of patients’ admissions, discharges/dispositions
- Adhere to all policies and procedures including but not limited to HIPAA Privacy
- Assist with other clerical tasks as needed
Care Review Processor
Molina Healthcare
01.2017 - 01.2018
- Responds to requests for authorization of services submitted via phone, fax, and mail according to Molina operational time frames
- Contact physician offices according to department guidelines to request the missing information from the authorization request or for additional information as requested by the Medical Director
- Eligibility and benefits verification for members, provider contracting status, and benefits status determination
Surgery Referral’s Team Leader
Leon Medical Centers
01.2011 - 01.2015
- Coordinate with the HMO and insurance department to give authorizations for procedures and surgeries
- Fax the prescription to the provider’s office with the patient’s demographic
- Fax medical clearance to the hospital and reschedule surgery cancellations as needed
- Schedules pre-op labs
- Ensures paperwork is received at the Hospital and Doctor’s office before the surgery date
- Heavy telephonic usage
Education
Medical Billing & Coding -
Penn Foster
01.2023
Associate Degree - Health Care Administration
Florida National University
Registered Behavior Technician - undefined
Florida Tech
Medical Assistant - undefined
Florida Career College
High School - undefined
Florida Christian Academy
Bachelor’s Degree - Psychology
Florida National University
01.2022
Skills
- Committed to delivering exceptional healthcare services while efficiently managing medical clerical duties
- Strong customer service skills, including greeting patients, scheduling appointments, verifying insurance coverage, and accurately entering data into Electronic Medical Records (EMR)
- Proficient in medical coding, with knowledge of CPT and HCPCS Level 10 codes
- Capable of typing 45-50 words per minute
- Demonstrates a strong work ethic, adaptability, and perseverance in fast-paced environments
- Excellent communication skills, facilitating clear and effective interactions with patients, providers, and team members
- Skilled in coordinating patient care from admission to discharge, optimizing resource utilization, and ensuring the delivery of high-quality healthcare services
- Collaborative team player with the ability to work closely with healthcare providers and stakeholders to improve patient care and outcomes
Languages
Spanish
Full Professional
English
Full Professional
Timeline
Utilization Management Coordinator
Claremedica Health Partner
01.2024 - Current
Medicare Care Coordinator
Mount Sinai Medical Center
01.2021 - 01.2023
Care Review Processor
Molina Healthcare
01.2017 - 01.2018
Surgery Referral’s Team Leader
Leon Medical Centers
01.2011 - 01.2015
Associate Degree - Health Care Administration
Florida National University
Registered Behavior Technician - undefined
Florida Tech
Medical Assistant - undefined
Florida Career College
High School - undefined
Florida Christian Academy
Bachelor’s Degree - Psychology
Florida National University
Medical Billing & Coding -
Penn Foster
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