Esteban Elias
Summary
Proven track record in enhancing provider relations and data management at Monarch HealthCare/Optum, showcasing expertise in documentation management and exceptional problem-solving abilities. Achieved significant improvements in quality assurance and customer satisfaction, leveraging multitasking skills for efficient quality assessments and audits.
Overview
16
16
years of professional experience
Work History
PDI Specialist
Optum
05.2022 - Current
- Follow all company policies and procedures to deliver quality work.
- Maintain data base consisting of new provider adds and demographic accuracy.
- Assist with Audits. (CalOptima)
- Create SOP's.
- Collaborate with departments to assist with correct provider documentation.
- Lead internal work group meetings to create rapport and help with creating SOP for each individuals job function.
- Training team with SB-137 attestation precess.
Provider Data Management Specialist
Monarch Healthcare/Optum
03.2015 - 04.2022
- Troubleshot data-related problems and coordinated maintenance or modifications to correct defects.
- Used standard document management tools to register documents and maintain databases used to produce logs, transmittal receipts and other reports.
- Formulated techniques for quality data collection to meet expected adequacy, accuracy and legitimacy targets.
- Verified compliance with data retention requirements by managing document catalogues for long-term archival of data associated with contract closeouts.
Provider Relations Coordinator
Monarch HealthCare
02.2013 - 02.2015
- Conducted regular provider audits to ensure compliance with company policies and industry regulations.
- Maintained accurate provider databases, ensuring up-to-date information was readily available for internal use and external reporting purposes.
- Participated in industry conferences or events, representing the organization professionally and developing valuable networking connections with potential providers.
- Monitored contractual agreements with providers, ensuring adherence to established terms and conditions while fostering positive working relationships.
Customer Service Representative
Monarch HealthCare
06.2008 - 01.2013
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
Education
GED -
Los Amigos High School
Fountain Valley, CA08.2002
Skills
- Customer Relations
- Expert Problem Solving
- Documentation Management
- Quality Assurance
- Multitasking
- Quality Assessment
- Excel
- Microsoft Word
- Microsoft Outlook
- Smartsheet
- Sugar/PRM
- EZ-Cap
- Practice Connect
Languages
Spanish
Professional Working
Accomplishments
- Achieved New Process by introducing a format for SB-137 attestation data collection.
- Achieved process efficiency through effectively helping create a new form that would populate provider data in a Word format form which helped removed entering manual data.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteHybridOn-SiteImportant To Me
Career advancementWork-life balanceCompany CultureFlexible work hoursHealthcare benefitsWork from home optionPaid time off401k matchPaid sick leaveStock Options / Equity / Profit Sharing4-day work weekTimeline
PDI Specialist
Optum
05.2022 - Current
Provider Data Management Specialist
Monarch Healthcare/Optum
03.2015 - 04.2022
Provider Relations Coordinator
Monarch HealthCare
02.2013 - 02.2015
Customer Service Representative
Monarch HealthCare
06.2008 - 01.2013
GED -
Los Amigos High School
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