Citlali E. Roberts
Referral coordinator
National City,United States
Summary
Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities. Trained in Epic use and administration with knowledge of HMO and PPO plans. Dedicated to excellent customer service and best-in-class collaboration. Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Overview
17
17
years of professional experience
Work History
Healthcare Authorization Specialist II
Rady Children's Hospital Of San Diego
02.2020 - 02.2024
- Educated patients on eligibility and affordability options by offering insightful information.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Communicated with people from various cultures and backgrounds on application process.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Provided primary customer support to internal and external customers.
- Trained new personnel regarding company operations, policies and services.
- Improved patient satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
Patient Access Rep I
Rady Children's Hospital Of San Diego
06.2007 - 02.2020
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
Education
No Degree - Dental Assisting
04.2000
High School Diploma -
06.1997
Skills
- Customer Satisfaction
- Referral Tracking
- Medical Terminology Knowledge
- Confidential Records Management
- Data Entry
- Information Assistance
- Gathering Referrals
- Customer Interaction
- Benefits Guidelines
- HIPAA Regulations
- Insurance Verification
- Prior Authorization Processing
- Professionalism
Timeline
Healthcare Authorization Specialist II - Rady Children's Hospital Of San Diego
02.2020 - 02.2024
Patient Access Rep I - Rady Children's Hospital Of San Diego
06.2007 - 02.2020
UEI College - San Diego - No Degree, Dental Assisting
Mar Vista Senior High School - High School Diploma,
Similar Profiles
Citlali E. RobertsCitlali E. Roberts
Healthcare Authorization Specialist II at Rady Children's Hospital Of San DiegoHealthcare Authorization Specialist II at Rady Children's Hospital Of San Diego
Kyle RoloffKyle Roloff
Registered Nurse at Rady Children's Hospital Of San DiegoRegistered Nurse at Rady Children's Hospital Of San Diego
AIME FELIX CASTROAIME FELIX CASTRO
Child and Family Specialist at Rady Children's Hospital Of San DiegoChild and Family Specialist at Rady Children's Hospital Of San Diego
JANET CoffeyJANET Coffey
Patient Financial Counselor at Rady Children's Hospital Of San DiegoPatient Financial Counselor at Rady Children's Hospital Of San Diego
Julian AyalaJulian Ayala
Assistant Manager at Sweet Things Frozen YogurtAssistant Manager at Sweet Things Frozen Yogurt