ILEANA MOLINA
Florissant,MO
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
12
12
years of professional experience
Work History
Retention Field Specialist
Centene Corp, Fidelis Care
03.2022 - Current
- Conducted telephonic and field outreach including events, provider and community office sites
- Assisting new and existing members with effectively explaining, communicating and assisting with all FIDELIS CARE products
- Provided member resolution by researching, analyzing and documenting inquiries regarding program eligibility
- Answer application questions and/or regarding program eligibility
- Served as liaison between member and different FIDELIS CARE departments
- Met and exceed assurance and quality standards at 93% June, 2023
- Performed job duties following all regulatory, compliance and corporate policies
- Documented all interactions in appropriate systems: Salesforce and facets including marketing leads
- Scouted community events in different markets connecting community relations team with several organizations
- Mentored/trained new hires with computer systems and web based application process for new and existing members
- Developed and maintained relationships with all members new and existing providing them with guidance or direct customer service assistance through out year
- Skilled at working independently and collaboratively in team environment
- Self-motivated, with strong sense of personal responsibility
Medical Receptionist
61st Service Corporation, NYP/Allen Hospital
03.2016 - 04.2021
- Meet and greet patients in professional cordial manner, maintain constant awareness patient flow and monitor patients in waiting area
- Managed office logistics by scheduling appointments, maintaining files and collecting payments
- Completed administrative patient intakes with case histories, insurance information and mandated forms
- Adhered to strict HIPAA guidelines to protect patient privacy
- Work within Experian to ensure all patient insurance information is verified and entered into IDX appropriately
- Obtained insurance referrals and pre-authorizations for specialists and procedures according to Managed Care guidelines
- Provide all check out functions including any ancillary testing required, pre-operative instructions, follow-up appointments and referrals given to patient
- File and scan patient documents and other medical information in appropriate folder within CROWN SCAN
- Order and maintains supplies, postage, and equipment
- Book procedure cases in OR manager, scan peri-operative documents into CROWN
- Handle provider reimbursements for conferences attended
- Processed payments for providers licenses, workshops, and conferences registrations’
- Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability
- Supported office staff and operational requirements with administrative tasks
Receptionist/Medical Biller/Sales
Rogot Optical
12.2011 - 02.2016
- Obtained and verified necessary patient-specific insurance information and authorizations
- Updated and maintained accurate and complete patient-related files and medical records
- Produced and delivered all required reports and billing statements, in timely manner
- Reconciled insurance payments with proper invoices
- Cooperated with manager and optometrist to ensure patient receives best care and satisfaction of eye-wear needs and wants
- Handled 20+ phone calls daily. Usage of fax and other common office machines
- Instructed patients in proper care and use of eye-wear or contact lenses
- Monitored and maintained cleanliness and orderliness of examination room and equipment
- Trained new hires on store procedures, fulfilling patient orders, and placing inventory orders
Education
Bachelor of Arts - Art Studio
City College of New York of The City University of New York, The
New York, NYAssociates - Applied Science in Electronic Media
Bronx Community College of The City University of New York
The Bronx, NYCertificate Omni-Channel Management -
Fashion Institute of Technology
New York, NYSkills
- SKILLS & LANGUAGES
- Office management software: Epic, Crown Insurances IVR systems, Microsoft Word, Microsoft Excel, Internet Savvy
- Ability to lead and train with expertise knowledge in different work areas: Epic Super User
- Customer service specialist
- Customer retention
Timeline
Retention Field Specialist
Centene Corp, Fidelis Care
03.2022 - Current
Medical Receptionist
61st Service Corporation, NYP/Allen Hospital
03.2016 - 04.2021
Receptionist/Medical Biller/Sales
Rogot Optical
12.2011 - 02.2016
Bachelor of Arts - Art Studio
City College of New York of The City University of New York, The
Associates - Applied Science in Electronic Media
Bronx Community College of The City University of New York
Certificate Omni-Channel Management -
Fashion Institute of Technology
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