EDNA LOMELI
San Antonio,TX
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
11
11
years of professional experience
Work History
Enrollment Coordinator
Patient Funding Alternatives
05.2023 - Current
- Patient helper at Christus Children's hospital. Assisted Medicaid families to enroll in Medicaid HIPP program.
- Provided policy information and maintained enforcement.
- Communicated details about cases to families serviced.
- Reached out to applicants via calls, texts, and email.
- Followed call scripts and flows to maximize effectiveness.
- Updated, entered and reviewed customer data.
- Communicated effectively via telephone, email and in person with prospective families
- Understood and thoroughly explained services provided to potential families.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Communicated with people from various cultures and backgrounds on application process.
- Interviewed applicants and explained scope of different available benefits.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Met or exceeded enrollment and retention goals consistently.
Supervisor
Steward Health Care, Texas Vista Medical Center
04.2022 - 04.2023
- Community Enrollment/ Medicaid Eligibility Texas, As supervisor, ran daily hospital census, assigned self pay patients for Medicaid eligibility screening to onsite team of four.
- Screen and assist with all steps of the Medicaid and Charity Care enrollment process
- Make follow-up phone calls to explain the Medicaid enrollment process and to enroll individuals in appropriate services such as health insurance
- Ensure timely submission of Medicaid or Charity application based off program guidelines
- Gather, verify, evaluate, and enter necessary social, financial, and medical information into various applications
- Outreach to individuals to determine Medicaid eligibility and continuing eligibility for income maintenance programs related to medical services
- Work with hospital team staff to identify difficult-to-reach clients and provide strategies for reaching them
- Meets in-person with patients in Emergency Room, Inpatient Floors.
- Meet or exceed daily standards for performance, accuracy, customer service, and quality
- Developed and implemented customer service policies to enhance satisfaction.
- Evaluated employee performance and coached and trained to improve weak areas.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Devised and implemented processes and procedures to streamline operations.
Veteran Care Specialist
Alamo Area Council Of Governments
01.2022 - 03.2022
- Implement and coordinate the case management in the region to ensure prescribed activities are carried out in accordance with specified objectives of the Veteran Directed Care Program.
- Provides technical assistance and develop spending plans for consumer directed services; Conducts and documents ongoing follow-up contacts and home visits.
- Served as a liaison between AACOG, Veterans Affairs (VA), Fiscal Management Agencies and social service agencies.
- Attends meetings, conferences, workshops and other in-service training programs related to the case management program and benefits counseling.
- Assists in developing the area plan and any necessary amendment program/benefits counseling program
- Liaison between AACOG, vendor regarding invoices; Completes related monthly reports.
- Performs other job related duties as assigned.
Bilingual Patient Advocate-Team Lead
MedData
01.2013 - 04.2021
- Liaised with staff from diverse hospital departments to bring about effective resolutions to range of issues
- Gathered and analyzed patient information to determine special program eligibility
- Documented patient activities, problems with coverage and hospital actions
- Managed database of patient information and frequently used computerized systems to track details
- Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
- Provided knowledgeable and compassionate service in response to all types of patient questions and concerns.
Education
High School Diploma -
Bolsa Grande High School
Garden Grove, CA06.2000
Skills
- Priority Management
- Employee Coaching
- Department Organization
- Applicant Screening
- Customer Accounts Management
- Progress Monitoring
- Data Entry Skills
- Enrollment Coordination
Languages
Spanish
Full Professional
Timeline
Enrollment Coordinator
Patient Funding Alternatives
05.2023 - Current
Supervisor
Steward Health Care, Texas Vista Medical Center
04.2022 - 04.2023
Veteran Care Specialist
Alamo Area Council Of Governments
01.2022 - 03.2022
Bilingual Patient Advocate-Team Lead
MedData
01.2013 - 04.2021
High School Diploma -
Bolsa Grande High School
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