Cynthia Sanchez
Tracy,CA
Summary
Highly qualified and reliable advanced medical support assistant with 23 years of experience in coordinating direct patient care. Skilled in managing fast-paced clinical modalities, including high-volume call center and pharmacy fulfillment environments. Compassionate toward every patient's specific needs, even in high-stress situations. A multitasking team player seeking full-time employment to utilize extensive education and work experience spanning over two decades.
Overview
22
22
years of professional experience
Work History
Advanced Medical Support Assistant
Department of Defense VA Hospitals
01.2022 - 01.2023
- Assisted Military Veterans with on going patient care with Primary Care and Specialty Care clinics
- Communicates with care teams via Microsoft Teams to assist with continuity of care
- High volume call center environment with on site and remote work locations adapting to changes as needed
- Maintained strict compliance with HIPAA regulations, ensuring the protection of sensitive patient information.
- Promoted effective communication among medical staff by serving as a reliable liaison between physicians, nurses, and administrative personnel.
- Provided exceptional customer service to patients, visitors, and colleagues, fostering a welcoming environment at all times.
- Assisted in training new staff members on clinic policies, procedures, and software systems for seamless integration into the team.
- Mailed patient appointment letters.
- Increased patient access to care by effectively coordinating referrals to specialists and diagnostic services.
- Scheduled appointments for primary care and specialties.
- Verified and updated clinical records.
- Supported efficient office operations through proficient handling of administrative tasks such as filing, data entry, and record maintenance.
- Collaborated with interdisciplinary teams to optimize patient care and facilitate seamless transitions between departments.
- Contributed to increased clinic efficiency by accurately maintaining electronic health records and promptly updating patient information.
- Handled prescription refills requests promptly under the supervision of healthcare providers for improved medication adherence among patients.
- Obtained client medical history, medication information, symptoms, and allergies.
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
Claims Analyst/Customer Service Representative
Blue Shield of CA
10.2021 - 11.2022
- Claims Rep- Assisted members with eligibility matters in addition to resolving all claims inquiries by auditing, adjusting and empowering claims
- Worked closely with medical providers to ensure accurate billing and payment processes for healthcare-related claims.
- Called on Providers offices to facilitate gathering of necessary medical justification documentation to expedite the claims adjudication process
- Created notices of billing, EOB's and managing deductible-balance billing
- Customer Service Representative- Prior to promotion to claims department was a team member for a Campaign calling on members to inquire if they needed any assistance regarding enrollment plan changes/premiums
- High volume eligibility call center explaining in detail Medicare Parts A & B while also assisting to resolve Billing/Premium inquiries & setting up autopay for premiums due
- Followed up with customers on unresolved issues.
- Provided exceptional customer service, addressing concerns and resolving issues promptly.
- Delivered personalized customer service, addressing policyholder concerns and clarifying coverage details.
- Calculated adjustments, premiums and refunds.
- Posted payments to accounts and maintained records.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Collected premiums and issued accurate receipts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Responded to customer requests for products, services, and company information.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Processed and recorded new policies and claims.
- Modified, updated and processed existing policies.
- Investigated claim details thoroughly to identify potential fraud or misrepresentation, protecting company assets.
- Expedited claim payments by effectively managing workload priorities and keeping accurate documentation records.
- Generated, posted and attached information to claim files.
- Maintained confidentiality of patient finances, records, and health statuses.
Customer Service Representative
Boral Industries
01.2019 - 05.2021
- Project Coordinator for builders/contractors to arrange roofing for all residential and commercial job sites
- Assisted distributors with purchasing process freight quotes & inventory quality control systems
Grade 4 Pharmacy Service Representative - Kaiser Certified Bilingual Pharmacy Customer Service Rep.
Kaiser Permanente Hospitals
10.2000 - 05.2011
- Managed KP.ORG pharmacy website
- Processed prescription transfers from outside pharmacies documenting vital clinical information for quality care
- Coordinated with Physicians to assure accurate medication dosage/directions both routine and urgent in nature
- Processed/audited skilled nursing facility orders for continuity of care
- Facilitated refund requisitions on behalf of patients for medications lost in transit from mail order delivery center
- Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
- Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
- Entered and processed patients' prescriptions into internal system.
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.
- Reduced wait times for customers by effectively managing multiple tasks simultaneously and prioritizing urgent requests.
- Assisted in the training of new pharmacy staff members, providing valuable guidance and support as they acclimated to their roles.
- Maintained patient confidentiality through diligent adherence to HIPAA regulations when accessing and updating medical records.
- Reported prescription errors to pharmacist on duty and adhered to company policies and procedures in relation to pharmacy errors and quality assurance directives.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Cross-trained and provided backup support for organizational leadership.
Education
Medical Billing And Coding, Administration - Medical Billing & Coding
Institute of Business Technology
Santa Clara08-2023
High School Diploma -
Lincoln High School
Stockton, CA01.1997
Skills
- Bilingual in Spanish
- Microsoft Word
- Excel
- Outlook
- SAP
- EMR
- CPRS
- Kareo
- Patient scheduling
- Continuous learning mindset
- Medical terminology
- Data entry proficiency
- Medical billing and coding
- Healthcare billing
- Electronic health records
Languages
Spanish
Professional Working
Timeline
Advanced Medical Support Assistant
Department of Defense VA Hospitals
01.2022 - 01.2023
Claims Analyst/Customer Service Representative
Blue Shield of CA
10.2021 - 11.2022
Customer Service Representative
Boral Industries
01.2019 - 05.2021
Grade 4 Pharmacy Service Representative - Kaiser Certified Bilingual Pharmacy Customer Service Rep.
Kaiser Permanente Hospitals
10.2000 - 05.2011
Medical Billing And Coding, Administration - Medical Billing & Coding
Institute of Business Technology
High School Diploma -
Lincoln High School
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