Berenicce B Montoya
National City,CA
Summary
Dedicated Patient Service Representative adept at handling high caseloads without sacrificing the quality of care. Operates in high-pressure environments while recommending the best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Case Manager
Deluxe Medical Supply
01.2020 - 11.2021
- Communicate with patients, insurance companies, doctor offices, hospitals, and skilled nursing facilities to facilitate delivery of medical equipment to patients and members
- Processed referrals which included reviewing provider's progress notes, prescription/referral, and requesting pre-authorization from member's insurance with specific HCPC codes in accordance to medical equipment needed
- Submit prior authorization for medical equipment directly through insurance portals
- Verify patient insurance eligibility and benefits
- Handle multi-line phone system
- Managed over 60 calls daily
- Meet with walk-in patients and provide detailed information based on medical equipment
- Work with hospitals on weekends and after hours to facilitate oxygen and medical equipment
- On-call duties included being available to existing patients 24/7 for malfunction of oxygen equipment or hospital beds
- Assist contracted Hospice Providers
- Work with EPIC, Brightree, Allscripts, And Ensocare for hospital discharges
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations, and procedural costs.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements
Assistant Site Coordinator
ARC
05.2017 - 12.2019
- Scheduled staff and volunteers to cover all necessary duties during planned events
- Coordinated site investigations, documented issues, and escalated to executive teams
- Acted as point of contact for parents' general questions about various programs offered
- Used pivot tables to create detailed accounting reports for school leadership
- Ensured safety of students on campus
- Develop daily lesson plans for enrichment activities
- Work collaboratively with all levels of staff
- Assisted in supervising projects, ensuring timely completion and adherence to safety standards
Education
Certificate Medical Office Administration - Health Administration
Concorde Career College
San Diego, CA03.2024
High School Diploma -
Grossmont High School
La Mesa, CA06.2012
Skills
- Knowledge of Medical Terminology
- Knowledge of ICD-10, CPT, HCPC
- Communicating effectively both verbally and in writing professionally
- 5 years experience in call center and customer service environment
- Ability to handle multi-line incoming customer calls, schedule appointments, and perform online registration
- 54 WPM
- Documentation Proficiency
- Medical Records Management
References
Personal and professional references available by request.
Certification
Medical Office Administration
Medical Terminology
Introduction to Medical Billing and Coding
Anatomy and Physiology
Languages
Spanish
Native or Bilingual
References
References available upon request.
Timeline
Case Manager
Deluxe Medical Supply
01.2020 - 11.2021
Assistant Site Coordinator
ARC
05.2017 - 12.2019
Certificate Medical Office Administration - Health Administration
Concorde Career College
High School Diploma -
Grossmont High School
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