Brenda Reyna
San Antonio,TX
Summary
Innovative, customer-oriented healthcare administrator with background in managed and long-term care. Strong background in quality assurance and management principles and practices.
Overview
10
10
years of professional experience
Work History
Referral Coordinator
Deer Oaks Mental Health Associates
09.2022 - 03.2024
- To review incoming referrals from nursing home facilities, requesting psychological and psychiatric services for residents at the home.
- Verify patients insurance eligibility, co-pays/ co insurance and benefit detail for our patient mental health.
- Assign patients to a psychologist and/or psychiatrist and notify the provider via email.
Service Coordinator
Superior Health Plan Inc
12.2021 - Current
- Answer calls in a timely manner.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs including but not limited to eligibility inquires, PCP changes, new ID card as well as provider listings.
Referral Specialist
Superior Health Plan
10.2020 - 12.2021
- Build emergency inpatient authorizations for admits such as medical, OB deliveries, rehab and transportation.
- Attach clinical documents
- Task authorization to a concurrent review nurse to be reviewed
Customer Service Representative
Humana
02.2020 - 07.2020
- Educate patients on eligibility and affordability options by offering insightful information.
- Collect payments for policy
- Assign sponsors to correct Military Treatment Facility
Program Coordinator
Superior Health Plan
03.2017 - 10.2019
- Process and triage all incoming faxes to the Health plan such as authorization renewal request for personal assistant services, adult day care services, emergency response services, home delivered meals, Durable medical equipment
- Communicate via fax with provider agencies and primary care providers
- Trained all new hire employees
- Subject matter expert for my co workers
Customer Service Representative
Superior Health Plan
11.2015 - 03.2017
- Call center setting
- Maintained customer happiness with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Offered advice and assistance to customers, paying attention to special needs or wants
- Verified members eligibility and covered benefits
Customer Service Representative
Mcna Dental Plans
11.2013 - 11.2014
- Call Center Setting
- Offered advice and assistance to customers, paying attention to special needs or wants
- Maintained customer happiness with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Asissted in verifying member eligibility and benifits
Education
Registered Dental Assistant - Dental
Kaplan Career Institute
San Antonio, TX04.2010
High School Diploma -
Brackenridge High School
San Antonio, TX05.2007
Skills
- Effective leader
- Process improvements
- Data management familiarity
- Proactive mindset
- Communication skills
- Data entry
- Microsoft word
- Microsoft excel
Timeline
Referral Coordinator
Deer Oaks Mental Health Associates
09.2022 - 03.2024
Service Coordinator
Superior Health Plan Inc
12.2021 - Current
Referral Specialist
Superior Health Plan
10.2020 - 12.2021
Customer Service Representative
Humana
02.2020 - 07.2020
Program Coordinator
Superior Health Plan
03.2017 - 10.2019
Customer Service Representative
Superior Health Plan
11.2015 - 03.2017
Customer Service Representative
Mcna Dental Plans
11.2013 - 11.2014
Registered Dental Assistant - Dental
Kaplan Career Institute
High School Diploma -
Brackenridge High School
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