Darlene Andrade
Fontana,CA
Summary
I am seeking a position in which I can apply my skills as an Office Manager/ and or Assistant. I have 21 years' experience, in Orthopedics and DME. I enjoy what I do best; Patient and Customer care.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Customer Service Representative 2
Charter Spectrum
04.2023 - Current
- Respond to customer requests for products, services, and company information.
- Update account information to maintain customer records.
- Maintain customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answer customer telephone calls promptly to avoid on-hold wait times.
- Clarify customer issues and determine root cause of problems to resolve product or service complaints.
- Follow up with customers about resolved issues to maintain high standards of customer service.
- Manage daily goal of approximately 40 or more incoming calls per day from customers.
Operations Manager
First Health DME
02.2017 - Current
- Responsible for managing and leading daily operations
- Aquire new contracts with Insurance plans and IPA's
- Strong understanding of Medicare, Workers Compensation, PPO, HMO, Commercial, and Government health plans, Extensive knowledge of different types of coverage policies including obtaining Prior Authorizations
- Verify patients insurance coverage to ensure services are covered by insurance provider
- Provide benefit coverage to patients as needed
- Implement procedure to maximize departments operating efficiencies
- Train and develop employees
- Sales rep for Southern California
- Calling on physicians, hospitals, skilled nursing facilities management and case managers within an assigned territory to promote our patient care services
- Build and maintain client relationships
- Prepare business plan and target list to prioritize accordance with the business plan to gain market and increase incoming referrals
- Run after hours referrals and set daily delivery schedules to our practitioners.
Authorizations Lead
OrthoKinetix DME
01.2016 - 02.2017
- Responsible for managing and leading the authorizations department
- Plan and implement procedures and systems to maximize departments operating efficiency
- Schedule departments meetings to ensure protocols and daily department goals are met
- Review medical records for all Medicare patients
- Follow up with all insurance companies to secure authorization and proper reimbursement
- Assign new orders within the department to better manage new orders
- Knowledgeable with HMO policies, procedures, utilizing insurance portals.
DME Specialist
DME
01.2015 - 01.2016
- Responsible for managing multiple orders for different doctors
- Obtain authorizations and added in detailed written orders into the patient's medical report
- Run benefits and eligibility for patients to provide an estimated cost to patient
- Measured patients for custom braces
- Applied and instructed patients on the use of their DME.
Education
Diploma - Health Management And Clinical Assistance
Nova INSTITUTE
Whittier, CA04.1999
Skills
- OFFICE MANAGER (8 years)
- SALES REPRESENTATIVE
- OPERATIONS (2 years)
- OPERATIONS MANAGEMENT
- PURCHASING (6 years)
- Prior Authorization
- Utilization Review
- Insurance Verification
- Workers' Compensation
- Medical office experience
- Facilities management
- Medicare
- EMR systems
- Medical records
- Process improvement
- Experience administering injections
- Management
- Medical scheduling
Certification
Medical Assistant, 04/01/99, Present
Additional Information
Skills & Abilities
Office Manager
Sales Representative
Customer Service Management
Operations Management
Team Building and Training
Purchasing/Inventory
Managed Multiple Departments
Exceptional Organizational and process skills
Proficient in Excel, Outlook, Microsoft.
Personal Information
- Title: Operations Manager
- Work Permit: Authorized to work in the US for any employer
Timeline
Customer Service Representative 2
Charter Spectrum
04.2023 - Current
Operations Manager
First Health DME
02.2017 - Current
Authorizations Lead
OrthoKinetix DME
01.2016 - 02.2017
DME Specialist
DME
01.2015 - 01.2016
Diploma - Health Management And Clinical Assistance
Nova INSTITUTE