Cristina Velazquez
Moreno Valley,CA
Summary
Provided over five years of healthcare administration and patient support experience focusing on medical records, claims work, clerical tasks, and release of information. Assisted in delivering exceptional customer support by exceeding expectations in resolving inquiries and providing service. Completed a bachelor's degree in healthcare administration and management. Employed meticulous attention to detail and strong communication skills while managing sensitive information and supporting administrative operations. Utilized EMR systems such as Elation, Canvas, Ciox, Datavant, Episource, Quick Sight, Helping Hand, ProviderLink, Honor Health, Facets, SFax, MFax, and more. Gained proficiency in Google Documents, Microsoft Word, Microsoft PowerPoint, Microsoft Teams, spreadsheets, Excel, Slack, Adobe, Webex, and Outlook.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Quality Review & Audit Senior Representative
Cigna Healthcare
06.2025 - Current
- Responsible for auditing, and problem-solving issues pertaining to retrieving and processing medical records and denied claims.
- Resolving Denied claims to obtain missing or incorrect information for the billing and coding team.
- Providing outreach to multiple facilities for claims obtainable such as w9 requests, itemized bills including revenue codes for each charge.
- Monitors all chart retrieval activities for chart projects, and performs actions as defined by department workflows, including tracking outstanding records, analyzing barriers to retrieval, evaluating chart availability, reviewing for completeness & problem solving.
- Performs outreach via telephone or secure fax to provider offices for requests including but not limited to additional information required, record delivery, and retrieved record deficiencies.
- Day to day quality audits on vendor chart records, responses, provider engagement, and related requirements.
- Ensures confidentiality and security of customer PPI/PHI by following all HIPAA, regulatory, and release-of-information protocols.
- Follows medical records policies for storage and retention.
- Maintains a daily production tracker, or other reporting, in a predetermined format.
- Performs chart processing, vendor pend resolution, provider research, and other tasks as required to execute on Risk Adjustment programs.
Medical Records Specialist
Firsthand Cares
04.2023 - 03.2025
- Monitored engagement status of individuals and sent appropriate requests for healthcare information to relevant facilities/providers.
- Retrieved medical records digitally in a timely manner to support pre-visit preparation and safe care planning.
- Prioritized requests based on the need and urgency of the visit date for the patient.
- Tracked all requests that were in progress in real-time to enable metrics reporting and efficiently uploaded all records received to chart.
- Faxed medical records requests to many facilities daily depending on the volume of appointments approaching for our individuals.
- Utilized EHR systems such as Elation, Quick sight, Helping Hand, Canvas, Sfax, Mfax, and more.
- Operated Adobe, Spreadsheet, PowerPoint, and Google Sheets.
- Experience with Google Meet, Google Documents, Microsoft, email, and Slack.
- Coordinated with healthcare providers and facilities to establish efficient information exchange channels, leveraging multiple communication platforms for optimal record acquisition outcomes.
- Would fax high volume of medical record requests monthly, and would successfully reach metric goals every month by completing those requests efficiently.
- Acquired great experience working fully remote and independently as well as in a fast-paced environment.
- Obtained appropriate authorization/consent forms and ensured HIPAA compliance.
- Used spreadsheet to input facility location and status of requests.
- Would request around 500 medical requests per month.
- Excellent communication skills when collaborating and making calls to facilities and healthcare providers.
- Completed around 25 calls a day to facilities regarding medical records request status.
Electronic Health Records Specialist
Included Health
08.2022 - 04.2023
- Maintained and obtained records the provider requested over time, including all key administrative clinical data relevant to a person's care under a particular provider.
- Ensured and reduced the incidence of medical error by improving the accuracy and clarity of medical records.
- Made health information available by reducing duplication of tests, reducing delays in treatment, and keeping patients well informed to make better decisions.
- Coordinated with healthcare providers and facilities to establish efficient information exchange.
- Indexed medical records once received, and uploaded to patients chart.
- Used different EMR systems for faxing and everyday tasks.
- Worked closely with the clinical team regarding specific records, labs, or imaging needed for each patient.
- Reviewed records to ensure we received the charts we need.
- 15 daily calls to physicians, facilities, and in some cases patients regarding medical records status.
- Utilized adobe for medical records indexing.
Medical Reorder Support Specialist
Advanced Diabetes Supply Pharmacy
01.2021 - 08.2022
- High volume of calls averaging around 80 calls daily.
- Call center environment.
- Provided patient/member support via email.
- Managed patients accounts regarding their reshipment/prescription items they were due for.
- Managed incoming and outgoing calls with a goal of 80 calls a day.
- Updated each patient's account accurately and efficiently.
- Provided excellent customer service while verifying and updating patient demographics.
- Ensured patients medical records, prescriptions, insurance, and diagnoses codes were accurate before sending out medical items.
- Sent out requests for documentation needed such as eligibility, insurance requests, faxing doctors for CMNs, and processing work orders.
- Verified which items (quantity, type) patients are due for reshipment and informed them of any copays or information needed.
Customer Service Specialist
Starcrest Products of California
Perris, CA
11.2020 - 01.2021
- Answered incoming calls in the customer service department.
- Placed phone orders, reviewed online orders, and handled item returns or exchanges.
- Accurately input information such as data entry regarding customer information and updating phone numbers, addresses, card/check numbers.
- Processed 100+ daily customer interactions across multiple channels (phone, email, letters), ensured accurate documentation and timely resolution of inquiries while maintaining comprehensive customer records.
- Filled out CST forms for the warehouse department for inventory adjustments regarding returns, exchanges, damaged merchandise, and missing items.
Customer Service Representative
Low Cost Interlock - Arrow Staffing
Redlands, CA
11.2019 - 02.2020
- Handled a high volume of calls for a DUI breathalyzer company with a goal of completing at least 60 calls a day.
- Entered client information into the system such as personal information, billing information, and notes regarding the reason for their call.
- Assisted with device troubleshooting, billing, and setting appointments at the service center for device placement or removal.
- Discussed fees and prices for device calibration, installation, device replacement, and override codes for devices.
- Informed clients about device warnings and rules to prevent missed tests.
- Collaborated with various service center associates to discuss client's device calibrations, installations, or removal of devices.
Theatre Associate
Regency Theatres
Moreno Valley, CA
06.2017 - 10.2019
- Worked in multiple departments such as door attendant, usher, box office, and concessions.
- Cleaned theaters after movies, assisted with crowd control, performed restroom checks, and covered co-workers breaks/lunches.
- Handled welcome greetings, collected tickets, directed guests to their theater room, performed bag checks, and assisted guests in the lobby.
- Assisted guests with ticket purchases, movie program information, and answered phone calls.
- Managed complex cash handling operations and rewards program administration while maintaining accurate transaction records and resolving customer inquiries.
- Assisted supervisors with projection during the process of a change-over cue when it was time to change movie film.
Education
High school diploma -
Canyon Springs High School
Bachelor of Science - Healthcare Administration & Management
California Baptist University
12.2022
Associates - Social Science
Crafton Hills College
05.2021
Skills
- PHI
- HIPAA
- EMR/EHR
- Customer Support
- Resolving Denied claims
- Data entry
- Attention to detail
- Collaborating with facilities
- Organization Skills
- Adaptability
- Communication
- Time Management
- Problem Solving
- Research
- Record management
- Remote Work
Certification
HIPAA Certification
Languages
English
Spanish
Linkedin Profile
www.linkedin.com/in/cristina-velazquez-career
Timeline
Quality Review & Audit Senior Representative
Cigna Healthcare
06.2025 - Current
Medical Records Specialist
Firsthand Cares
04.2023 - 03.2025
Electronic Health Records Specialist
Included Health
08.2022 - 04.2023
Medical Reorder Support Specialist
Advanced Diabetes Supply Pharmacy
01.2021 - 08.2022
Customer Service Specialist
Starcrest Products of California
11.2020 - 01.2021
Customer Service Representative
Low Cost Interlock - Arrow Staffing
11.2019 - 02.2020
Theatre Associate
Regency Theatres
06.2017 - 10.2019
High school diploma -
Canyon Springs High School
Bachelor of Science - Healthcare Administration & Management
California Baptist University
Associates - Social Science
Crafton Hills College