Summary
Overview
Work History
Education
Skills
Activities
Timeline
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Catalina I. Cardoza

Santa Ana,CA

Summary

Dynamic Insurance Verification Specialist with extensive experience at Orthopedic Associates of Southern California. Proficient in insurance verification and claims processing, I excel in data analysis and customer communication. Recognized for enhancing patient satisfaction and streamlining verification processes, I bring a strong understanding of medical records management and a commitment to confidentiality.

Overview

7
7
years of professional experience

Work History

Insurance Verification Specialist

Orthopedic Associates Of Southern California
Tustin, California
01.2024 - Current
  • Verified insurance coverage for patients receiving orthopedic services.
  • Communicated with insurance providers to obtain necessary authorizations.
  • Reviewed patient information for accuracy and completeness prior to verification.
  • Collaborated with healthcare staff to resolve any insurance-related inquiries.
  • Documented verification processes in electronic health record systems.
  • Educated patients on their insurance benefits and coverage options.
  • Maintained up-to-date knowledge of insurance policies and regulations.
  • Assisted in training new staff on verification procedures and best practices.
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Updated patient and insurance data and input changes into company computer system.
  • Navigated through multiple online systems to obtain documentation.
  • Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
  • Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Responded promptly to customer inquiries regarding their benefits and eligibility status.
  • Maintained confidentiality of patient information in accordance with HIPAA regulations.

Service Coordinator

Memorialcare Home Health
Laguna Hills, California
03.2023 - 01.2024
  • Assessed client needs to recommend appropriate services and resources.
  • Explained solutions that effectively addressed client pain points.
  • Resolved service delivery issues to ensure client satisfaction.
  • Managed appointment scheduling for clients to optimize service access.
  • Maintained and tracked client service records for accurate reporting.
  • Documented customer interactions to enhance service quality.
  • Answered phone calls and emails to provide timely support.
  • Evaluated service offerings, identifying areas for improvement and growth.

Teacher's Assistant

St. Joseph School
Santa Ana, California
09.2022 - 03.2023
  • Assisted teacher in preparing lesson outlines, plans, and curriculum for assigned subjects.
  • Tutored individual students and small groups to reinforce understanding of lessons.
  • Supported students through social and behavioral challenges, guiding them in new curriculum.
  • Motivated students while supervising during school trips and activities.
  • Attended meetings to ensure effective communication regarding student progress.
  • Monitored children consistently during breaks and playtime to maintain safety.
  • Prepared lesson materials, graded assessments, and provided constructive feedback on student work.

GENERAL CLERK/Medical Billing Specialist

Change Healthcare
Newbury Park, California
02.2022 - 08.2022
  • Reviewed claims, documented patient information in database, and processed appeals efficiently.
  • Scanned payment batches, charges, and correspondence into Citrix system for record-keeping.
  • Mailed daily correspondence, created cover sheets for paperwork and batches to ensure organization.
  • Processed payments, collected statements and checks, and issued refund mailings promptly.

Retail Sales Associate

Nike Factory Store
Thousand Oaks, California
09.2021 - 02.2022
  • Engaged customers through suggestive selling, driving increased sales and product selection.
  • Greeted customers warmly, ensuring a positive shopping experience.
  • Responded promptly to customer inquiries, providing accurate information.
  • Sorted and stocked merchandise, maintaining proper pricing and placement.
  • Managed merchandise transfers between stores efficiently.
  • Organized back of store operations, preparing for next day tasks.
  • Handled phone calls and cash transactions while utilizing mobile devices for efficiency.

Patient care coordinator/Medical Records

Providence Home Health
01.2021 - 09.2021
  • Collected demographic information from various sources and communicated with registration areas and physicians' offices.
  • Initiated medical records by creating and processing patient care record folders.
  • Retrieved medical records by adhering to chart-out procedures and documenting retrieval issues for follow-up.
  • Delivered charts to designated hospital areas in accordance with established routing procedures.
  • Informed health care providers of record availability to ensure timely access to information.
  • Ensured compliance with hospital standards to maintain quality results in record-keeping.
  • Documented actions, irregularities, and ongoing needs to support continuity of operations.
  • Protected patient confidentiality by securely managing sensitive records.

ATTRACTIONS/Amusement Ride Operator

Disneyland California Adventure
Anaheim, California
05.2019 - 09.2021
  • Delivered exceptional customer service for operations at various exhibits and shows.
  • Assisted guests in safely enjoying attractions and events.
  • Provided accurate park information and addressed guest inquiries.
  • Greeting guests, loading and unloading attractions, and operating systems were key responsibilities.
  • Controlled audience engagement by delivering narrations of varying lengths.
  • Executed duties as attractions cast member across indoor and outdoor locations.

Patient Service Representative

Breastlink
Newport Beach, California
06.2020 - 01.2021
  • Greeted incoming patients and visitors with professionalism and courtesy.
  • Registered patients, ensuring accurate collection of insurance and personal information.
  • Verified updates in patient, physician, and insurance data to facilitate proper billing.
  • Collected co-pays and fees efficiently during patient registration.
  • Answered phone inquiries and scheduled patient appointments promptly.
  • Guided patients through procedures, addressing questions and concerns empathetically.
  • Notified team members of patient arrivals, coordinating with back-office staff for timely care.
  • Updated exam orders upon physician request by contacting primary care providers.

Patient Service Representative

RadNet
Santa Monica, California
09.2019 - 02.2020
  • Greeted and directed patients to examination rooms efficiently.
  • Scheduled patient appointments and made reminder calls.
  • Informed patients about delays and waiting times promptly.
  • Obtained and verified patients’ addresses, contact details, insurance information, and medical histories.
  • Assisted patients with completion of history, consent, and payment contract forms as needed.
  • Processed cash and credit card payments for medical services rendered.
  • Performed administrative duties such as filing paperwork when required.

Education

ASSOCIATES DEGREE - Nursing Education

Santa Ana College
Santa Ana, California, CA
01.2022

Skills

  • Microsoft Office Suite
  • Data analysis and reporting
  • Multi-line phone operation
  • Fax and copier management
  • Email communication
  • Scanning and document handling
  • EPIC and Onco systems
  • Wellsky and ERIS proficiency
  • Teams collaboration
  • Devero software usage
  • Insurance verification and billing
  • Office Ally and Availity navigation
  • Claims processing
  • Medical records management
  • Referral request handling

Activities

  • Volunteer: Emergency Room, CHOC Children’s Hospital, 11/01/19, 05/01/21, Greet visitors and escort family as they arrive., Assist in office clerical support., Assess the comfort needs of families on the many units., Assist in discharging patients., Offer activities for patients who are in our waiting/ lobby areas., Restocking supplies and assisting nursing staff so that it allows them to focus on their patients.
  • Volunteer: Patient Service & Information Desk, Fountain Valley Regional Hospital, 08/01/16, 01/01/17, Received and dispatched calls from Admitting and Nursing for patient admissions and discharges., Provided accurate updates on the volunteer chart of patients entering and completing surgery., Assisted families and visitors by providing location of patients., Responds to nursing requests, aid with discharge of patients by providing wheelchair accompaniment of patients to the waiting area., Notified family members via telephone when a patient will be able to receive visitors., Complied with HIPAA regulations and sensitive organizational information confidential., Complied with the policies and procedures of the organization.

Timeline

Insurance Verification Specialist

Orthopedic Associates Of Southern California
01.2024 - Current

Service Coordinator

Memorialcare Home Health
03.2023 - 01.2024

Teacher's Assistant

St. Joseph School
09.2022 - 03.2023

GENERAL CLERK/Medical Billing Specialist

Change Healthcare
02.2022 - 08.2022

Retail Sales Associate

Nike Factory Store
09.2021 - 02.2022

Patient care coordinator/Medical Records

Providence Home Health
01.2021 - 09.2021

Patient Service Representative

Breastlink
06.2020 - 01.2021

Patient Service Representative

RadNet
09.2019 - 02.2020

ATTRACTIONS/Amusement Ride Operator

Disneyland California Adventure
05.2019 - 09.2021

ASSOCIATES DEGREE - Nursing Education

Santa Ana College
Catalina I. Cardoza