Isaias Marzuca
Houston
Summary
Bilingual healthcare professional with over 8 years of experience supporting Medicaid and Medicare services. Skilled in healthcare administration, appeals and grievances, and assisting members with state and federal funding programs. Proven ability to communicate effectively, manage time efficiently, and work collaboratively with cross-functional teams. Passionate about improving patient outcomes and navigating complex healthcare systems.
Overview
9
9
years of professional experience
Work History
Community Outreach Specialist
Devoted Health
11.2023 - 05.2025
- Enhanced community engagement by assisting members with applications & state funding.
- Evaluated program success using various metrics by screening members for qualifying benefits out side of plan.
- Conducted needs assessments to identify areas requiring additional support or resources within the community or state.
- Increased public awareness of available resources by providing detailed information to each member of programs available to them based on income & reaching out directly to local resources.
- Provided support and education to Medicare members across multiple states, ensuring their access to care and services.
- Screened members for Medicaid, SNAP, LIS, and other state-funded benefit programs.
Community Health Worker
Devoted Medical
10.2022 - 11.2023
- Connected families with necessary social services, alleviating barriers to healthcare access and improving quality of life.
- Built trust within diverse communities through cultural competency training, empathetic communication skills, and active listening techniques.
- Addressed patient concerns and provided support to vulnerable demographics.
- Participated in ongoing professional development opportunities to stay current on best practices in community health work, ensuring the delivery of quality services to clients.
- Worked directly with patient treatment teams and participated in care coordination procedures.
Lead Member Service Representative
Texas Children's Health Plan
02.2020 - 09.2023
- Assist members with complex issues pertaining to appeals & grievances. .
- Led regular team meetings focused on sharing best practices, boosting overall departmental proficiency.
- Conducted timely follow-up calls with members after issue resolution, ensuring complete satisfaction and strengthening member relationships.
- Analyze & perform call audits to identify areas of improvement.
- Monitored team performance metrics closely, providing constructive feedback and coaching as needed to maintain optimal productivity levels across all representatives.
Senior Clinical Administrative Coordinator II
United Healthcare Group
11.2017 - 11.2019
- Coordinated medical referrals for patients from DME, LTC, RX, Transportation, Appeals, Grievances, Billing ensuring seamless transitions between providers and continuity of care.
- Strengthened patient-provider relationships through timely communication and attentive service during office visits.
- Ensured compliance with healthcare regulations and policies, maintaining accurate patient records and documentation.
- Served as liaison between clinical departments, fostering collaboration on initiatives aimed at improving patient care services across the organization.
Advocate 4Me Representative
United Healthcare Group
03.2016 - 11.2017
- Worked effectively with fellow team members to coordinate effective solutions to any question or concern.
- Delivered friendly service and offered expert support in every interaction.
- Established trusting relationships with clients by maintaining open lines of communication throughout the entire representation process.
- Managed complex call from submitting appeals & continuity of care forms.
- Assisted with insurance verification for members with vendors & providers.
Education
Waltrip Highschool
Houston, TX05-2013
Skills
- Case Management
- Community engagement
- Partnership development
- Research
- Service coordination
- State medicare & medicaid guidelines
Languages
Spanish
Native or Bilingual
Timeline
Community Outreach Specialist
Devoted Health
11.2023 - 05.2025
Community Health Worker
Devoted Medical
10.2022 - 11.2023
Lead Member Service Representative
Texas Children's Health Plan
02.2020 - 09.2023
Senior Clinical Administrative Coordinator II
United Healthcare Group
11.2017 - 11.2019
Advocate 4Me Representative
United Healthcare Group
03.2016 - 11.2017
Waltrip Highschool
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