Elizabeth Mendez
Oxnard,CA
Summary
To obtain a position where clerical and customer service can be utilized to successfully execute the opportunity. Hardworking medical administrative professional offers great people skills, organized file management and deep understanding of patient protections. Enhances office operations by staying on top of patient and staff needs. Experience with electronic recordkeeping and insurance documentation.
Overview
6
6
years of professional experience
Work History
HS Client Benefit Specialist
Ventura County Human Services
Ventura, California
04.2024 - Current
- Assist applications and recipients of multiple public assistance programs by interactively interviewing the applicant/recipient to obtain financial, employment, and personal demographic information, and entering the information into online, automated eligibility systems.
- Interview clients and/or family members individually and/or in group settings to obtain the required information to establish financial status and verify eligibility for Medi-Cal benefits.
- Explain services, benefits, program requirements, and governmental procedures.
- Assess financial, personal, and social information to determine applicant need, validate the system-determined benefit, and authorize the issuance of the benefit.
- Contact individuals, public and private agencies, businesses, and other resources to verify information by telephone or by mail.
- Process applications, forms, and reports, enter case information, and record contacts into automated systems, and maintain paper and electronic case files.
- Meet regulatory and automated system deadlines in a timely manner, in accordance with local, state, and federal compliance regulations, as well as internal performance standards.
- Determine the need for additional services and provide them appropriately, in an integrated, collaborative effort.
- Prepare a variety of written correspondence related to client eligibility, activity, and services provided.
- Take all appropriate actions to increase approval and retention rates.
Office Manager/Billing
Stan's Drugs Inc.
Oxnard, CA
12.2019 - 03.2024
- Conducted insurance verification and pre-authorization, coded procedures and managed patient profiles.
- Managed billing calendar and scheduled claims for payments.
- Enforced operational compliance with state and federal laws and Medicare and State Board standards.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Customer Service, heavy phone communications
- Constant communications with doctors, nurses medical professionals, insurance companies, vendors, patients and families for Rx related concerns.
- Attention to detail, dependability , quality focus, analyzing information and creating an effective work environment all tribute to positive outcomes for customers and staff.
- Assist health care providers and patients with pharmacological questions and requests; referring inquires to pharmacists; maintain pharmacy inventory by checking pharmaceutical stock to determine inventory level; anticipating needed medications and supplies; placing and expediting orders; verifying receipt;
- Generate revenue calculating, recording and issuing charges; Durable equipment billing for Medi Cal and Medicare.
Hospital Medical Office Assistant-Registration
VCMC
Ventura, CA
01.2023 - 05.2023
- Compiles routine reports, records, and charts by extracting and/or tabulating information from a variety of sources such as files, reports, notes, logs, correspondences, and/or verbal instruction: identifies variations in data (MOA II)
- Reviews and manages patient schedules to anticipate for missed opportunities, scheduling errors, registration form updates, insurance eligibility and co-payments.
- Handles high volume of patients, internal/externals customers, and frequent changes, delay or unexpected events.
- Checks patients in-and out through the practice management system and verifies information.
- Performs cashiering duties and collects co-payments, and outstanding balances.
- Communications with patient care team to endure that patient care needs are addressed.
- Monitors waiting areas and ensures areas are maintained clean.
- Assists with pre-visit planning and confirm appointments.
- Accurately enters and updates demographics and payer data in practice management system.
- Verifies coverage and payor eligibility, which may include programs, private insurances, and Medi-Cal. Performs financial screenings for program eligibility. Requests pre-authorization when needed.
- May assist patients in coordinating appointments with diagnostic or specialty services.
- May transcribe medical documents (MOAII)
- Operates a variety of automated office equipment including computers.
- Performs other related duties as required.
Education
Certification - Medical Assisting
Oxnard Adult School
Oxnard, CA02.2010
High School Diploma -
Hueneme High School
Oxnard, CA06.2000
Skills
- Problem Anticipation and Resolution
- Financial Resources Management
- Team Building Leadership
- Data Analysis
- Quality Assurance
- Bilingual
- Willing to learn
- Time management
- Customer service
- Management
- Communications
- Documentation and reporting
- Pre-registration documentation
- Verbal and written communication
- Insurance verification
- Demographic information
- Multitasking and prioritization
- Office organization
- Interpersonal and written communication
- Records management
- HIPAA procedures
- Payment processing
- Medical terminology
- Appointment scheduling
- Working through knowledge of rules and regulations governing eligibility for appropriate governmental programs, departmental forms, and procedures
- Private and public community resources for client referrals
- Conducting complex interviews, both in person and over the telephone
- Utilize a variety of automated computer systems
- Proficient in Microsoft Word
- Establish and maintain cooperative working relationships with people of diverse socioeconomic backgrounds and levels
- Prepare routine narrative and statistical reports as required
- Communicate effectively, both orally and in writing
- Make accurate arithmetical calculations
- Understand and carry out complicated verbal and written instructions, and directions
Timeline
HS Client Benefit Specialist
Ventura County Human Services
04.2024 - Current
Hospital Medical Office Assistant-Registration
VCMC
01.2023 - 05.2023
Office Manager/Billing
Stan's Drugs Inc.
12.2019 - 03.2024
Certification - Medical Assisting
Oxnard Adult School
High School Diploma -
Hueneme High School
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