Francine Sandoval
Albuquerque,NM
Summary
Proven leader at New Mexico Cancer Center, adept in workflow management and patient insurance authorizations, enhancing team productivity and patient satisfaction.
Excelled in roles requiring analytical thinking and exceptional client service, demonstrating a commitment to excellence and effective communication. Reliable, organized, and proficient in navigating complex healthcare systems with excellent communication and problem-solving skills.
Achieved significant improvements in operational efficiency and customer care.
My analytical thinking and attention to detail led to significant improvements in patient care coordination, demonstrating a strong blend of hard and soft skills.
Skilled in managing prior authorization processes, ensuring compliance, and improving efficiency.
Strong focus on team collaboration and achieving results, adaptable to changing needs.
Overview
13
13
years of professional experience
Work History
Billing Prior Authorization Lead
New Mexico Cancer Center
Albuquerque, New Mexico
12.2013 - Current
- Directed and supervised a team of eight employees in daily operations.
- Collaborated with other departments to coordinate workflow processes between teams.
- Provided guidance and direction to subordinates regarding job duties and responsibilities.
- Acted as a liaison between upper management and staff, facilitating open communication.
- Trained new employees on company policies, job duties, and performance expectations.
- Evaluated employee performance through periodic reviews and documented results accordingly.
- Participated in recruitment efforts by interviewing prospective candidates for open positions.
- Developed strategies to improve team performance and productivity.
- Resolved customer complaints in a timely manner while ensuring customer satisfaction.
- Maintained accurate records of employee performance, attendance, leave requests, and disciplinary actions.
- Monitored employee productivity to provide constructive feedback and coaching.
- Helps with coverage and obtains prior authorization for radiation therapy, internal and external beam, chemotherapy, radiology, rheumatology, pharmacy authorizations, genetics, and neurology.
- Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations.
Patient Care Coordinator/ Medical Assistant
New Mexico Cancer Center
Albuquerque, New Mexico
12.2013 - 04.2017
- Set up coordination for home health aides or durable medical equipment suppliers in order to provide an appropriate level of care.
- Collaborated with multidisciplinary teams in order to provide comprehensive patient centered care.
- Assisted physicians in performing various procedures related to patient care needs.
- Manages the internal and external assignment of orders, and conducts follow-ups to ensure that patients attended their scheduled appointments.
- Provided ongoing communication with patients, families, and providers regarding treatment plans and progress.
- Validate that prior authorization or referral is secured prior to a scheduled procedure or test, alerting stakeholders (patient, patient representative, OR, etc.). If a breakdown occurs.
- Monitor and track the Data Quality program to ensure errors are corrected at the time of service.
- Assisted physicians with patient care by taking vital signs, patient histories and preparing patients for examinations.
- Prepared laboratory specimens for analysis and organized lab results for review by the physician.
- Adhered to HIPAA regulations regarding safeguarding confidential patient information at all times.
- Assisted with pre-operative preparation of patients including providing instruction about post-operative care plans.
- Performed basic laboratory tests, such as urinalysis levels, under the direct supervision of a physician or registered nurse.
- Kept examination rooms clean, stocked with necessary supplies and prepared for incoming patients.
- Organized patient charts before each day's clinic sessions began.
Patient Care Coordinator
Lovelace Medical Center
Albuquerque, New Mexico
12.2011 - 12.2013
- Entered data regarding patient demographics, diagnoses, treatments, procedures, and charges accurately into billing systems.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation.
- Performs appointment scheduling for patients via the telephone or in person, to include testing, radiology CT planning, radiation treatments, internal and external beam, and clinician appointments. Biopsy, port placement.
- Secure financial payment at the time of service, including co-insurance, copayments, self-pay, and deductible monies due.
- Explain the documents that require patient or representative signatures.
- Monitors and reports on the quality and quantity of work through self-reporting.
Education
GED -
CNM
Albuquerque01-2004
Skills
- Prescription coordination
- Patient insurance authorizations
- Client service
- Medical terminology
- Benefit coverage
- Follow-up skills
- Electronic refill request processing
- Verbal and written communication
- Analytical thinking
- Workflow management
- Attention to detail
Accomplishments
Worked my way up to leadership showing that I can excel in any area placed and able to meet deadlines, excellent organizational skills able to multi-task and prioritize workload under pressure, proficient in medical terminology. Strong communication skills, time management skills, Team player, Keen attention to detail.
Timeline
Billing Prior Authorization Lead
New Mexico Cancer Center
12.2013 - Current
Patient Care Coordinator/ Medical Assistant
New Mexico Cancer Center
12.2013 - 04.2017
Patient Care Coordinator
Lovelace Medical Center
12.2011 - 12.2013
GED -
CNM
Similar Profiles
Baylee ThachBaylee Thach
Medical Assistant at New Mexico Cancer CenterMedical Assistant at New Mexico Cancer Center
Donna FintoDonna Finto
Triage RN/Oral Chemotherapy Nurse at New Mexico Cancer CenterTriage RN/Oral Chemotherapy Nurse at New Mexico Cancer Center
Johnna SandovalJohnna Sandoval
Triage Nurse at New Mexico Cancer CenterTriage Nurse at New Mexico Cancer Center