BERENICE PALOMERA GUZMAN
Renton,WA
Summary
Detail-oriented Patient Care Coordinator overseeing patient journeys from consultation to post-operative care. Expertise in surgical scheduling, prior authorizations, financial counseling, and pre-operative preparation. Experienced in insurance verification and benefits investigation, facilitating timely authorizations and collaboration with medical teams to enhance patient satisfaction and support practice growth.
Overview
9
9
years of professional experience
Work History
Patient Care Coordinator
The Polyclinic Part of Optum- Plastic & Reconstructive Surgery
2021.08 - Current
- Coordinated patient care from consultation through surgery, ensuring seamless transitions and continuity of services.
- Scheduled surgeries while aligning OR and provider availability to optimize patient flow.
- Collaborated with surgeons, nurses, anesthesia, and surgical teams.
- Managed multiple cases in a fast-paced environment.
- Processed patient estimates and payments accurately, facilitating timely financial resolutions.
- Prepared and submitted prior authorization requests and supporting documentation.
- Monitored authorization status and followed up on pending requests.
- Communicated approval, denial, and appeal outcomes.
- Resolved patient insurance inquiries and provided guidance on coverage requirements.
- Assured regulatory compliance and professionalism across patient service.
- Coordinated patient care with outside medical clinics and providers.
Patient Service Representative II Lead
The Polyclinic Part of Optum- Allergy, Asthma & Immunology
2018.02 - 2021.08
- Scheduled appointments and coordinated follow-up care with clinical staff.
- Managed patient check-in and check-out.
- Processed referrals and prior authorization requests for specialty allergy services.
- Maintained accurate patient records, including medical histories and insurance information, to support quality patient care.
- Entered patient registration data in Epic to keep records current and accurate.
- Answered high volumes of phone calls, documented detailed information, and directed calls to appropriate departments.
Education
High School Diploma -
Mount Rainier High School
Des Moines, Washington2012-06
Skills
- Microsoft Office
- EPIC & Optime
- HIPAA compliance
- Surgical scheduling
- Insurance authorizations
- Authorization Requirements
- Benefits eligibility
- Medical terminology
- Coding knowledge
- Effective Patient Communication
- Patient advocacy
- Surgical coordination
- Detail orientation
- Time management
- Conflict resolution
- Communication
- Team oriented
- Project management
- Remote teamwork
- Problem solving
- Organizational skills
- Bilingual communication
Timeline
Patient Care Coordinator
The Polyclinic Part of Optum- Plastic & Reconstructive Surgery
2021.08 - Current
Patient Service Representative II Lead
The Polyclinic Part of Optum- Allergy, Asthma & Immunology
2018.02 - 2021.08
High School Diploma -
Mount Rainier High School