Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Brandon Loeza

Santa Barbara,CA

Summary

Knowledgeable and dedicated customer service professional with extensive experience in healthcare, and a dependable,hardworking individual with a positive demeanor and solid team player skills. Seeking a supervising position that offers professional challenges and bring interpersonal skills to help team achieve departmental goals.

Overview

16
16
years of professional experience

Work History

Clinical Support Associate

CenCal Health
05.2023 - Current
  • Demonstrated adaptability by quickly learning new procedures or technologies, contributing to a more efficient and knowledgeable clinical support team.
  • Improved patient care by efficiently managing clinical support tasks and maintaining organized patient records.
  • Championed a positive work environment through proactive communication, active listening, and fostering strong professional relationships with colleagues.
  • Adhered diligently to HIPAA requirements when handling sensitive patient information to maintain confidentiality at all times.
  • Answered provider inquires and provided information on authorization status and/or information needed for auth review.
  • Provide assistance with Appeal packets and making available for G&A Team upon email request.
  • Provided coaching and mentoring to new hires, contributing to their successful integration into the team.

Member Service Representative

CenCal Health
02.2016 - 05.2023
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
  • Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
  • Maintained high-quality service by adhering to company policies and standards in all member interactions.
  • Collaborated with team members to ensure seamless operations during peak hours or staff shortages.
  • Assisted members with filing grievances and appeals and understanding procedure.
  • Educated members about billing processing and filing policies and procedures.
  • Exhibited high energy and professionalism when dealing with members, providers, and staff.
  • Partnered with other departments facilitating smooth resolution of complex cases resulting in improved member experience.

Medical Service Coordinator

Sansum Clinic
06.2014 - 01.2016
  • Maintained current and accurate medical records for patients.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Processed medical insurance claims and payments.
  • Greeted visitors and initiated triage processes for clients to streamline patient flow.
  • Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
  • Obtained payments from patients and scanned identification and insurance cards.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Coordinated patient scheduling, check-in, check-out and payments.

for billing.

  • Transcribed phone messages and relayed to appropriate personnel.
  • Printed prescription requests and queries in compliance with practice protocol.
  • Kept waiting room neat and organized by stacking magazines, removing trash, and cleaning
    glass.
  • Checked patient insurance, demographic, and health history to keep information current.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
  • Helped patients complete necessary medical forms and documentation.
  • Supported office staff and operational requirements with administrative tasks.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Adhered to strict HIPAA guidelines to protect patient privacy.
  • Completed patient referrals to other medical specialists.
  • Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.



Billing Specialist

Westside Neighborhood Clinic
10.2009 - 05.2014
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
  • Enhanced customer satisfaction with timely and accurate invoice generation.
  • Enhanced interdepartmental communication to ensure accuracy and completeness of billing information.
  • Enhanced accuracy in patient billing through meticulous record-keeping and verification of insurance details.
  • Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.
  • Improved customer satisfaction with prompt and clear communication regarding their billing inquiries.
  • Filed and updated patient information and medical records.
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
  • Performed medical records management, including filing, organizing and scanning documents.
  • Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
  • Maintained a safe and clean clinical environment by adhering to infection control guidelines and disposing of biohazardous waste properly.
  • Facilitated seamless patient care with thorough and accurate documentation of medical histories, vital signs, and medications.
  • Improved patient experiences by efficiently managing appointments and maintaining organized medical records.
  • Reduced wait times by swiftly processing insurance claims, verifying coverage, and obtaining pre-authorizations when necessary.

Education

San Marcos High School
Santa Barbara, CA
06-2009

Skills

  • HIPAA compliance
  • Teamwork and collaboration
  • Attention to detail
  • Patient care
  • Excellent communication
  • Adaptability and flexibility
  • Active listening
  • Membership/Provider Inquiries and Issue resolution
  • Data entry
  • Call center experience
  • Relationship building
  • Customer service

Languages

Spanish
Native or Bilingual

Timeline

Clinical Support Associate

CenCal Health
05.2023 - Current

Member Service Representative

CenCal Health
02.2016 - 05.2023

Medical Service Coordinator

Sansum Clinic
06.2014 - 01.2016

Billing Specialist

Westside Neighborhood Clinic
10.2009 - 05.2014

San Marcos High School