Crystal Aguirre
San Diego,CA
Summary
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
14
14
years of professional experience
Work History
Authorizations and Eligibility Supervisor
Seaport Scripps Home Health
03.2021 - Current
- Performed eligibility assistance, case management, referrals or related function.
- Complied with department, organization and government policies and procedures.
- Uploaded and submitted verification documents and completed applications.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Evaluated employee performance and coached and trained to improve weak areas.
- Established team priorities, maintained schedules and monitored performance.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Liaised between patients, insurance companies, and billing office.
Administrative Coordinator
Health & Wellness Center
03.2020 - 03.2021
- Supported office staff and operational requirements with administrative tasks.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Prepared patient charts by gathering and organizing medical records ahead of appointments.
- Relayed care and medication advice to patients to relieve physicians during peak hours.
- Performed various administrative tasks by filing, copying and faxing documents.
- Assisted with medical coding and billing tasks.
- Placed new supply orders, managed inventory and restocked clerical spaces.
- Oversaw accounting, budgeting, and financial reporting.
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties.
- Coordinated office events, seminars and meetings for staff and clients.
- Completed bi-weekly payroll for 30 employees.
- Created reports, presentations and other materials for executive staff.
Scheduling Specialist
United Healthcare
05.2018 - 03.2020
- Called customers to coordinate schedules and set appointments.
- Answered phone calls and answered questions from potential customers.
- Acted as first point of contact and set appointments for prospective clients.
- Documented calls and appointments using Hawkeye.
- Implemented time-blocking and schedule notifications to optimize time management.
Customer Service Supervisor
Best Buy
04.2010 - 03.2018
- Coached employees through day-to-day work and complex problems.
- Responded to customer inquiries and resolved complaints to establish trust and increase satisfaction.
- Developed and maintained strong relationships with customers to maintain loyalty and satisfaction.
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Conducted training and mentored team members to promote productivity, accuracy, and commitment to friendly service.
- Identified customer service trends to provide recommendations for process and procedural improvements.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
Education
High School Diploma -
Chula Vista High School
Chuls=a Vista06.2000
Skills
- Quality Assurance
- Delegation Skills
- Time Management
- Conflict Resolution
- Process Improvement
- Leadership Abilities
Languages
Spanish
Native or Bilingual
Timeline
Authorizations and Eligibility Supervisor
Seaport Scripps Home Health
03.2021 - Current
Administrative Coordinator
Health & Wellness Center
03.2020 - 03.2021
Scheduling Specialist
United Healthcare
05.2018 - 03.2020
Customer Service Supervisor
Best Buy
04.2010 - 03.2018
High School Diploma -
Chula Vista High School
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