BERNADETTE LOPEZ
Los Angeles,CA
Summary
Insurance Specialist with expertise in insurance eligibility and authorization verification. Demonstrates strong commitment to regulatory compliance and exceptional customer service. Proven ability to streamline processes and enhance patient satisfaction.
Overview
1
1
Language
19
19
years of professional experience
Work History
Insurance Eligibility Specialist
Memorial Care Shared Services
Fountain Valley, California
03.2026 - Current
- Evaluated patient eligibility for services at Memorial Care Long Beach Medical Center.
- Processed eligibility and verified documentation for accuracy and completeness.
- Communicated with patients to gather necessary information for eligibility and estimate assessments.
- Coordinated communication between patients and healthcare providers effectively.
- Explained reasons behind denials and recommended further action.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
Insurance Verification Representative
Memorial Care Long Beach Medical Center
Long Beach, California
07.2007 - 03.2026
- Verified patient insurance eligibility and benefits information efficiently.
- Educated patients on insurance coverage and billing procedures effectively.
- Trained new staff on verification procedures and best practices.
- Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Responded promptly to patient inquiries about their policies and provided timely updates as needed.
- Coordinated with other departments within the organization regarding issues related to policy administration.
- Calculated premiums and established payment methods, receiving customer payments and issuing receipts.
- Verified medical authorizations ensuring accuracy and validity.
- Proficient in the computer software program EPIC.
- Knowledge of commercial, Medi-cal, Medicare advantage policies and third party administrators.
- Adhered to HIPAA guidelines when handling confidential information.
Education
Associate of Science -
Cerritos College
Norwalk, California, CA06-2003
Skills
- Insurance eligibility and verification
- Patient education
- Policy administration
- Premium calculation
- EPIC proficiency
- Cross-department collaboration
- Claims management
- Knowledge of Medi-Cal, commercial and third party payors
- Authorization verification
Languages
Spanish
Professional
Timeline
Insurance Eligibility Specialist
Memorial Care Shared Services
03.2026 - Current
Insurance Verification Representative
Memorial Care Long Beach Medical Center
07.2007 - 03.2026
Associate of Science -
Cerritos College