Evelina Rodriguez
Santa Paula,CA
Summary
A compassionate licensed vocational nurse with a strong work ethic who wants to continue building relationships with patients, and peers. Focused on communicating, organizing and meeting needs of patients in home health, schools, residential and private duty settings.
Overview
24
24
years of professional experience
Work History
Service Representative
Kaiser Permanente
Woodland Hills, CA
02.2018 - Current
- Acts as first point of contact for Kaiser Permanente members/patients and assists members/patients through registration process under minimal direct supervision.
- Practices proper cash handling and reconciliation processes in accordance with established policies and guidelines.
- Member and patient needs should be primary focus of one's actions; develops and sustains productive member/patient relationships.
- Actively seeks information to understand member/patient circumstances, problems, expectations, and needs.
- Establishes and builds rapport and cooperative relationships with public/members/ staff.
- Responds quickly to meet member/patient needs and resolve problems using good judgment. Functionality may differ based upon operational setting.
Personal Trainer
Fit N Fine Fitness / Personal Training
Santa Paula, CA
10.2012 - Current
- Designed specific workout systems for individual clients based on performance ability.
- Trained clients during strength training, cardio vascular exercise and stretching.
- Developed, planned and led personal and group fitness sessions as well as well-known specialty fitness programs.
- Explained exercise modifications and contraindicated movements to participants with history of injury.
IUR Coordinator
Anacapa Surgical Associatess
Ventura , CA
11.2014 - 02.2018
- Gathered and organized materials to support operations.
- Received and responded to customer requests via letters, emails, telephone calls and in-person interactions.
- Entered data, generated reports and produced tracking documents.
- Coached employees through day-to-day work and complex problems.
- Verify Insurance eligibility, and benefits
- Review structured clinical data matching it against specified medical terms and diagnosis or procedure codes, and follow established procedures for authorizing request or referring request for further review
- Evaluates the pre-service authorization request received for scheduled inpatient admissions, ambulatory surgeries, outpatient services and out of network providers
- Ensure that prior authorization requests are completed in a timely fashion
Enrollment and Billing Rep III
Anthem Blue Cross
Newbury Park , CA
05.2006 - 09.2012
- Responsible for group enrollment, billing activities and maintaining assigned accounts. Essential duties to include: responding to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers.
- Verifying enrollment status, making changes to records as needed, researching and resolving enrollment system rejections; addressing variety of enrollment questions or concerns received by phone or mail.
- Responsible for all billing and delinquency processes for assigned groups. Ensure accuracy and timeliness of membership and billing function. Respond to inquiries concerning enrollment processes.
- Maintain enrollment database. Bill, collect premiums and reconcile payments. Notify clients of premium discrepancies through payment adjustment notices and detailed audits. Perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
Education
Licensed Vocation Al Nurse - Nursing Education
Career Care Institute - Oxnard
Oxnard CA03.2022
High School Diploma -
Santa Paula High School
Santa Paula, CA06.2003
Skills
- Procedure Explanation
- Collecting Vitals
- Nursing Intervention Evaluations
- Medication Side Effect Knowledge
- Immunization Administration
- Call Answering and Assistance
- Upbeat and Positive Personality
- Calm and Professional Under Pressure
Timeline
Service Representative
Kaiser Permanente
02.2018 - Current
IUR Coordinator
Anacapa Surgical Associatess
11.2014 - 02.2018
Personal Trainer
Fit N Fine Fitness / Personal Training
10.2012 - Current
Enrollment and Billing Rep III
Anthem Blue Cross
05.2006 - 09.2012
Licensed Vocation Al Nurse - Nursing Education
Career Care Institute - Oxnard
High School Diploma -
Santa Paula High School
Similar Profiles
Marie A. StevensonMarie A. Stevenson
Patient at Patient FinancialAdvisor, Kaiser Permanente Eligibility and FinancialServices, FinancialAdvisor, Kaiser PermanentePatient at Patient FinancialAdvisor, Kaiser Permanente Eligibility and FinancialServices, FinancialAdvisor, Kaiser Permanente
Edith NagunaEdith Naguna
Special Needs Program Care Mgt RN Consultant at Kaiser Permanente - Southern California Permanente Medical GroupSpecial Needs Program Care Mgt RN Consultant at Kaiser Permanente - Southern California Permanente Medical Group
MICHAEL NAVAMICHAEL NAVA
Area Director at Kaiser Permanente – The Permanente Medical GroupArea Director at Kaiser Permanente – The Permanente Medical Group
Diana IovescuDiana Iovescu
Program Manager III- Centers for Reproductive Health/IVF at Kaiser Permanente- The Permanente Medical GroupProgram Manager III- Centers for Reproductive Health/IVF at Kaiser Permanente- The Permanente Medical Group
Arthur RiveraArthur Rivera
Private Investigator at RAM Attorney InvestigationsPrivate Investigator at RAM Attorney Investigations