Guadalupe Menendez
Tracy ,USA-CA
Summary
Dedicated Claims Admin Specialist with a strong focus on wage calculation accuracy and compliance. Recognized for problem-solving abilities and attention to detail, contributing to team success and improved outcomes during DWC audits.
Overview
22
22
years of professional experience
Work History
Claims Admin Specialist 2
The Zenith
Dublin, California
05.2017 - Current
- Calculate wage statements for full time, intermittent/occasional, concurrent, and seasonal earnings by using best practices in conjunction with CERT and DWC regulations.
- Thoroughly document calculation rationale to support any adjustments, presumptions, gaps, start/end dates, omissions, and inclusions in our calculations.
- Set appropriate diaries for the examiner and CSS indicating wage calculation completion and adjustment due dates.
- Correspond with examiners to help educate and inform on our calculation process and results.
- Map out payment dates using the statutes for Ochoa and advise Examiner so that payment decisions can be made timely.
- Work with CERT to resolve any wage statement accuracy findings.
- Recalculate wages for claims affected by minimum wage increases at the city, county, or state level.
- Provide quality assurance on wage statement calculations, serving as a "second set of eyes" for your peers in my absence.
- Improve wage statement calculation accuracy with an accuracy goal of 85.0%.
- Provided support during DWC audits by explaining processes and documentation requirements.
- Actively participate in CERT team meetings and any upcoming projects that might hold particular interest.
Production Associate
Tesla
Fremont, California
12.2016 - 05.2017
- Loaded and unloaded materials from production lines safely and efficiently.
- Maintained cleanliness and organization of the work area for safety and efficiency.
- Reported equipment malfunctions promptly to maintenance for timely repairs.
- Worked quickly and efficiently while maintaining high standards of quality control.
- Recognized defective material and reported issues to management.
- Ensured compliance with company policies and procedures at all times.
Certified Medical Assistant
John Muir Medical Center
Pleasanton, California
02.2013 - 11.2016
- Assisted physicians with patient examinations and treatments.
- Streamlined patient scheduling and maintained accurate appointment records.
- Delivered compassionate care to patients in various medical settings.
- Conducted vital sign assessments and documented findings to support patient care.
- Collaborated with healthcare teams to enhance patient care delivery.
- Maintained medical equipment and ensured cleanliness of exam rooms.
- Administered injections, immunizations, medications, wound dressings and other treatments according to physician instructions.
- Prepared treatment rooms by ensuring cleanliness and restocking necessary supplies for patient readiness.
- Conducted diagnostic tests such as EKGs or hearing screenings in accordance with established protocols.
Certified Medical Assistant
Sutter Gould Medical
Tracy, California
10.2003 - 02.2013
- Assisted physicians and nurses with patient exams, including taking vital signs, preparing exam rooms, and updating medical records.
- Assisted physicians with patient examinations and treatments.
- Administered injections, immunizations, medications, wound dressings and other treatments according to physician instructions.
- Administered medications and monitored patient responses to ensure safe and effective treatment.
- Coordinated patient scheduling and maintained accurate appointment records to optimize clinic workflow.
- Delivered compassionate care to patients in various medical settings.
- Educated patients on treatment plans and preventive care options.
- Collaborated with healthcare teams to enhance patient care delivery.
- Maintained medical equipment and ensured cleanliness of exam rooms.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Performed diagnostic tests such as EKGs and hearing screenings following established protocols to support accurate diagnosis.
Education
Medical Assistant Diploma - Medical
Western Career College
San Leandro, CA06-1998
Skills
- Claims processing
- Regulatory compliance
- Wage calculation
- DWC audits
- Quality assurance
- Risk assessment
- Data analysis
- Problem solving
- Attention to detail
- Time management
- Team collaboration
Timeline
Claims Admin Specialist 2
The Zenith
05.2017 - Current
Production Associate
Tesla
12.2016 - 05.2017
Certified Medical Assistant
John Muir Medical Center
02.2013 - 11.2016
Certified Medical Assistant
Sutter Gould Medical
10.2003 - 02.2013
Medical Assistant Diploma - Medical
Western Career College