Summary
Overview
Work History
Education
Skills
Languages
Certification
Timeline
Generic

Francisco Duarte

Tucson,AZ

Summary

Experienced, bilingual Health Care Administrative Professional dedicated to providing exceptional care to patients, families, and care teams. Efficiently manages administrative tasks and ensures smooth operations in healthcare settings. Friendly, adaptable, and collaborative, excels at devising satisfying solutions to complex problems. Committed to delivering high-quality service and fostering positive relationships with all stakeholders.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Experienced Bilingual (Spanish) Customer Service

Geico
12.2024 - Current
  • First point of contact answering approximately 50 calls regarding billing questions, making policy changes and providing recommendations.
  • Versatile professional with strong problem-solving skills and history of adapting to diverse challenges. Applies innovative solutions and technical expertise to deliver exceptional results. Committed to streamlining processes and advancing organizational objectives.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Maintained up-to-date knowledge of product and service changes.
  • Implemented and developed customer service training processes.

Patient Care Coordinator

Coram CVS Specialty Infusion Services
08.2020 - 09.2024
  • Delivered excellent patient experiences and direct care approximately 30 patients per day.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Resolved customer complaints using established follow-up procedures.
  • Worked with patients to ascertain issues and make referrals to appropriate specialists.
  • Compiled and maintained patient medical records to keep information complete and up-to-date.

Bilingual Customer Service Representative

OptumRx
10.2018 - 05.2020
  • Identified and responded to customer requests and concerns through incoming calls for both English and Spanish-speaking customers.
  • Managed approximately 60 incoming calls per day from customers.
  • Communicated with management when customer issues escalated and worked to find resolutions.
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.

Medical Records Clerk

United Community Health Center
01.2018 - 10.2018
  • Maintained patient records in compliance with security regulations.
  • Managed approximately 30 incoming call, emails and faxes per day from customers and doctors offices.
  • Maintained patient confidence by keeping patient records information confidential.
  • Uploaded physician progress notes, history, and physicals into electronic medical records.
  • Processed medical records requests from outside providers according to facility, state, and federal law.
  • Scanned medical records in digital format for easy retrieval and accessibility.

Imaging Support Specialist I

Radiology Ltd
08.2016 - 01.2018
  • Act as liaison between radiology technologists and radiologists concerning patient images and medical information.
  • Initiate standards and methods for quality evaluation of images.
  • Communicates with Radiologists and technologists to resolve issues.
  • Scans and enter accurate information into the Document Management system and PACS systems.
  • Order and prepare priors studies for radiologists for comparison with current study.
  • Process final reports, make corrections as needed and deliver to courier or fax to provider office.
  • May also assist other administrative staff with overflow work, including special projects, word processing, data entry and internet research tasks.
  • Receive and prepare all non-digitized exams ensuring all patient information from outside clinics were present and accurate.

Customer Service Representative

APAC Customer Services, Inc
10.2012 - 07.2013
  • Analyze customer inquiries and information by effectively using online resources and gather information needed to process claims and adjustments.
  • Managed approximately 50 incoming calls per day from customers.
  • Responded to customer requests for products, services, and company information.
  • Investigated and resolved accounting, service and delivery concerns.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Identified and resolved discrepancies and errors in customer accounts.

Integrated Service Specialist DMEPlus

Coventry Healthcare
02.2011 - 04.2012
  • Ordering durable medical equipment via email, fax, and phone and by web and negotiating rates with in-network and out of network providers.
  • Scheduling home nursing, home health services, and outpatient therapies prior to discharge.
  • Scheduling transportation and lodging services to the customer and client needs.
  • Oversee authorizations/denials for durable medical equipment by email, fax, telephonic and by web.
  • Analyze customer inquiries and information by effectively using online resources and gather information needed to process claims and adjustments.
  • Evaluated systems according to predetermined checklist and noted issues.

Education

Associate of Applied Science - Health Care Administration

Brown Mackie College
Tucson, AZ
09.2015

High School Diploma -

Santa Rita High School
Tucson, AZ
05.2001

Skills

  • Collaborative Team Development
  • Adaptable to Change
  • Dependable and Detail-Oriented
  • Office Support Functions
  • Proficient in Spanish Communication
  • Expertise in Microsoft Office
  • Conflict Resolution
  • Effective Communication
  • Data-Driven Decision Making
  • Diverse Cultural Insights
  • Operational Planning
  • Networking Proficiency
  • Detail-Oriented Approach
  • Skilled in Microsoft Word Functions
  • Analytical Problem Solving
  • Effective Time Management
  • Effective Verbal Communication
  • Data Analysis
  • Proficient in Software Tools
  • Insurance verification
  • Workflow optimization
  • Cross-functional teamwork
  • Policy adherence
  • Medical billing
  • HIPAA compliance
  • Appointment scheduling
  • Healthcare operations
  • Healthcare documentation
  • Medical record requests
  • Administrative supervision
  • HIPAA protocol adherence
  • Insurance practices
  • Healthcare system navigation
  • Patient documentation
  • Patient outreach and Follow-up
  • Patient records management
  • Medical terminology
  • Filing and recordkeeping
  • Medical data collection
  • Patient care coordination
  • Healthcare

Languages

Spanish
Native or Bilingual

Certification

  • Insurance Producer/Personal Lines License - 02/24/2025 - 02/28/2029

Timeline

Experienced Bilingual (Spanish) Customer Service

Geico
12.2024 - Current

Patient Care Coordinator

Coram CVS Specialty Infusion Services
08.2020 - 09.2024

Bilingual Customer Service Representative

OptumRx
10.2018 - 05.2020

Medical Records Clerk

United Community Health Center
01.2018 - 10.2018

Imaging Support Specialist I

Radiology Ltd
08.2016 - 01.2018

Customer Service Representative

APAC Customer Services, Inc
10.2012 - 07.2013

Integrated Service Specialist DMEPlus

Coventry Healthcare
02.2011 - 04.2012

Associate of Applied Science - Health Care Administration

Brown Mackie College

High School Diploma -

Santa Rita High School

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Francisco Duarte