Estefania Guerra
Redlands,CA
Summary
Certified Medical Assistant with previous medical office experience. Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience. Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
8
8
years of professional experience
Work History
UM Outpatient Coordinator
Inland Empire Health Plan, Care Management
Rancho Cucamonga , CA
02.2022 - Current
- Conducted initial review of requests for medical necessity and appropriateness of services in accordance with benefit plan criteria.
- Evaluated the need for additional information from providers or members to support a request for service authorization.
- Communicated clinical decisions verbally and or in writing to other health care professionals and members as appropriate.
- Responded timely to inquiries regarding prior authorization status, expedite referrals and correction requests from providers via telephone.
- Knowledge in working with Medical and Medicare members.
- Kept detailed documentation on all utilization reviews by using Medhok.
- Reviewed and evaluated clinical documentation submitted by providers with authorization requests to ensure referrals were processed accurately.
- Participated in daily huddles with team members in order to discuss team performance, goals and new updates.
- Maintained high levels of professionalism while interacting with customers via phone.
- Offered resolutions to de-escalate calls and solve customer issues.
Medical Assistant
Dr. O'Reilly
San Bernardino , CA
04.2018 - 07.2021
- Conducted patient interviews to gather health history, vital signs and information about current medical issues.
- Conducted insurance verification and pre-certification and pre-authorization functions.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Adhered to HIPAA regulations regarding safeguarding confidential patient information at all times.
- Administered medications under physician's supervision.
- Answered phones, scheduled appointments and managed patient flow while greeting visitors in a professional manner.
- Inspected equipment to ensure proper working order prior to use on patients.
- Ensured that all instruments used during exams were cleaned properly after each use according to established protocols.
- Organized patient charts before each day's clinic sessions began.
- Assisted with pre-operative preparation of patients including providing instruction about post-operative care plans.
Office Manager/Administrative Assistant
T-Rex Auto Transport
Loma Linda , CA
11.2015 - 03.2018
- Responsible of providing a great customer service experience, assisted customers by providing quotes of their transportation prices, professional intake of calls, communicated with truck drivers to inform of any major changes or any new customer requests, responsible of sending out any billing matters to our billing company
- Scheduling appointments for customers and maintaining an accurate billing log for the office.
- Monitored shipment progress and provided timely updates to customers regarding arrivals or delays.
Amazon Warehouse Associate
Amazon.com
San Bernardino , CA
12.2015 - 02.2017
- Received and processed outbound shipments, verifying accuracy of items picked against purchase orders.
- Unloaded materials from trucks using pallet jacks.
- Packed goods for shipment in accordance with customer instructions.
- Operated a variety of material handling equipment including electric pallet jacks, hand-held scanners, shrink wrap machines and conveyor systems.
- Ensured compliance with established safety procedures when operating machinery or performing physical tasks within the warehouse environment.
Education
Diploma - Medical Assistant
Summit College
03.2018
High school diploma -
Redlands Adult School
06.2017
Skills
- Bilingual / Spanish
- Microsoft Word
- EMR systems
- ICD-10
- Patient care
- Medical receptionist
- Phone etiquette
- Multi-line phone systems
- Medical scheduling
- Insurance Verification
- Typing
- Medical office experience
- CPT Coding
- Medical terminology
- HIPAA Compliances
- Appointment Setting
Languages
Spanish
Native/ Bilingual
References
References available upon request.
Timeline
UM Outpatient Coordinator
Inland Empire Health Plan, Care Management
02.2022 - Current
Medical Assistant
Dr. O'Reilly
04.2018 - 07.2021
Amazon Warehouse Associate
Amazon.com
12.2015 - 02.2017
Office Manager/Administrative Assistant
T-Rex Auto Transport
11.2015 - 03.2018
Diploma - Medical Assistant
Summit College
High school diploma -
Redlands Adult School
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