Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Elvira Yvette Garza

Edinburg,Texas

Summary

Dedicated and results-oriented professional with a degree in Criminal Justice and extensive experience in client advocacy, case management, and healthcare compliance. Skilled in educating clients on programs and services, maintaining accurate documentation, and adhering to confidentiality regulations. Proven ability to collaborate with multidisciplinary teams and community organizations to deliver holistic support and coordinate essential services, including housing, legal assistance, and public benefits.

Adept at crisis intervention, addressing client concerns, and fostering positive outcomes through goal-setting and tailored support plans. Strong organizational skills enable effective management of multiple cases, tracking progress, and adjusting strategies as needed. Experienced in administrative and clinical support, patient eligibility verification, and healthcare information management, ensuring strict adherence to HIPAA and regulatory standards.

Proficient in Microsoft Office Suite and healthcare management systems, with excellent communication, leadership, and time management abilities. A collaborative team player with a proactive approach to enhancing operations, improving client satisfaction, and achieving organizational goals.

Overview

24
24
years of professional experience

Work History

Care Review Processor

Molina Healthcare
02.2012 - 12.2023
  • Delivered comprehensive telephone, clerical, and data entry support for the Care Review team, ensuring seamless operational workflows.
  • Accurately entered authorization requests and provider inquiries into the system, including eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits, hospital admissions and discharges, and billing codes.
  • Processed service authorization requests received via phone, fax, and mail, adhering to Molina's operational timeframes and quality standards.
  • Communicated with physician offices following departmental guidelines to obtain missing or additional information for authorization requests, facilitating efficient review by the Medical Director.

Case Manager

Texas Department Of Aging And Disability Services
04.2009 - 01.2012
  • Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
  • Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
  • Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
  • Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
  • Developed and implemented comprehensive case management plans to address client needs and goals.
  • Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
  • Enhanced team collaboration by leading regular case review meetings, promoting unified approach to client care.
  • Improved client outcomes by developing and implementing comprehensive case plans tailored to individual needs.
  • Monitored clients' progress and tracked client services to provide crisis interventions.
  • Coordinated essential services for clients, resulting in improved overall well-being and selfsufficiency.
  • Assisted clients in setting achievable goals while providing ongoing encouragement and support throughout the process of reaching those objectives.
  • Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies.
  • Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources.
  • Improved client satisfaction by efficiently addressing concerns or grievances in a timely manner.

Clerk

Texas Department Of Aging And Disability Services
01.2008 - 03.2009
  • Collaborated with team members to complete tasks efficiently and meet deadlines.
  • Organized office operations by maintaining files, records, and inventory.
  • Facilitated communication between departments by forwarding messages and scheduling meetings.
  • Ensured accuracy in data entry and document processing with attention to detail.
  • Scheduled appointments, prepared meeting materials, and took detailed minutes.
  • Assisted administrative staff with daily tasks to ensure smooth office operations.
  • Conducted research and compiled information to support team projects.
  • Provided professional and courteous communication with clients and colleagues.
  • Managed calls, directed inquiries, and took accurate messages.
  • Processed and distributed mail promptly and accurately.
  • Trained new employees on office procedures and tools.
  • Used multitasking skills to manage priorities and complete assignments on time.
  • Delivered quality clerical support through data entry, document management, and correspondence.
  • Organized customer documents for easy access and retrieval.
  • Monitored and restocked office supplies as needed.
  • Scheduled and coordinated meetings and travel arrangements.
  • Edited and proofread documents for accuracy.
  • Produced reports and maintained detailed records of office activities.
  • Supported special projects and streamlined office processes for efficiency.

Mail Carrier

Donna and Edinburg Post Office
01.2005 - 12.2007
  • Delivered mail and packages promptly and professionally while maintaining customer relationships.
  • Followed USPS policies to protect mail integrity and customer information.
  • Responded to inquiries and resolved concerns efficiently.
  • Used portable devices to scan and track deliveries accurately.
  • Maintained safety, organized vehicle workspace, and adhered to traffic laws.
  • Handled high-volume seasonal deliveries and ensured timely service.
  • Participated in training and contributed to process improvements.
  • Achieved perfect attendance and ensured accurate mail sorting and delivery.

Coordinator II, UCP

Hidalgo County Urban County
01.2000 - 12.2004

Responsible for program implementation of various federal and state grant programs offered through the county’s Urban County department.

Responsible for preparing and reviewing applications for grant funding of various community programs.

Prepared and recommended approval of project eligibility, environmental review, and citizen participation documents.

Assisted in the preparation of public notices and conducting public meetings.

Analyzed data for planning and publication.

Coordinated funding deadlines with municipalities, citizen groups, and/or other community organizations.

Maintained all related project documentation including but not limited to request for payments, procurement compliance, site visits and inspections, and bid process request.

Prepared monthly, quarterly, and annual activity reports.

Provided technical assistance and support regarding program rules and regulations to other local departments.

Performed all other related duties as assigned.

Education

Bachelor of Science - Bachelor of Science in Criminal Justice

The University of Texas Rio Grande Valley
Edinburg, TX
12.2024

GED -

Edinburg High School
Edinburg, TX
05.1986

Skills

  • Healthcare Compliance: Skilled in adhering to healthcare regulations, including HIPAA, to ensure confidentiality and compliance
  • Administrative & Clinical Support: Proficient in delivering administrative and clinical support to streamline operations and maintain workflow efficiency
  • Patient Eligibility & Information Management: Experienced in verifying patient eligibility and managing access to health information with strict privacy adherence
  • Community Collaboration: Expertise in utilizing community resources and collaborating with multidisciplinary teams to enhance patient care
  • Technical Skills: Proficient in Microsoft Office Suite and healthcare management systems to support organizational goals
  • Professional Communication: Strong telephone etiquette and assertiveness in addressing patient and provider inquiries effectively
  • Time Management: Skilled in prioritizing tasks and managing workflows to meet deadlines efficiently
  • Teamwork & Leadership: Collaborative team player with proven ability to lead initiatives that improve organizational effectiveness
  • Case Management: Expertise in assessing client situations, developing comprehensive plans, and monitoring progress to address individual needs
  • Client Advocacy: Skilled in educating clients about programs, benefits, and services to empower informed decision-making
  • Documentation & Compliance: Proficient in maintaining accurate records and ensuring compliance with confidentiality regulations
  • Collaboration: Strong ability to work with multidisciplinary teams, healthcare professionals, and community organizations to provide holistic support
  • Service Coordination: Experienced in coordinating essential services such as housing, legal assistance, and public benefits to improve client well-being
  • Crisis Intervention: Capable of monitoring client services and providing crisis interventions as needed
  • Problem Solving: Adept at addressing client concerns and grievances promptly to improve satisfaction
  • Goal Setting & Support: Skilled in helping clients establish achievable goals and providing encouragement to meet objectives
  • Leadership: Experience in leading case review meetings to enhance team collaboration and improve outcomes
  • Interpersonal Communication: Strong communication skills for building relationships with clients and stakeholders
  • Program Knowledge: Familiarity with community-based programs and resources to assist clients effectively
  • Organizational Skills: Proven ability to manage multiple cases, track progress, and adjust strategies as needed

Languages

Spanish
Native or Bilingual
English
Native or Bilingual

Timeline

Care Review Processor

Molina Healthcare
02.2012 - 12.2023

Case Manager

Texas Department Of Aging And Disability Services
04.2009 - 01.2012

Clerk

Texas Department Of Aging And Disability Services
01.2008 - 03.2009

Mail Carrier

Donna and Edinburg Post Office
01.2005 - 12.2007

Coordinator II, UCP

Hidalgo County Urban County
01.2000 - 12.2004

Bachelor of Science - Bachelor of Science in Criminal Justice

The University of Texas Rio Grande Valley

GED -

Edinburg High School
Elvira Yvette Garza